Pregnancy and Kidney Disease

For a patient with chronic kidney disease, questions about sexuality are often intertwined with questions about pregnancy.

Can a woman who is on dialysis have a child?

Usually not. Most female dialysis patients do not have regular periods. The use of erythropoietin (EPO) has improved some women's overall health, which can result in a greater chance of pregnancy. If a patient becomes pregnant, she usually has a miscarriage. Only rarely has a dialysis patient been able to have a baby, and then only after increasing treatments, changes in diet and medications, and more frequent doctor visits. Pregnancy adds stress to the healthy body and can put the dialysis patient and the unborn child at greater risk. Being unable to have a baby can cause feelings of loss. Since people in our society expect married couples to have children, a childless woman may question her role. She may feel incomplete or unfulfilled in her role as a woman, which may lead to feeling negative about herself and her sexuality. As a way of coping, she should talk openly about her feelings and needs with her partner and/or health care staff. Other options, such as adoption or becoming a foster parent, may also be available.

Is it possible for a man who is on dialysis to father a child?

Yes. Men who are on dialysis or who have received a kidney transplant can father children. A couple should seek professional help if they have tried for at least a year to have a child without success. A man can have a routine fertility checkup.

Is becoming pregnant easier for a kidney transplant recipient than for a dialysis patient?

Yes. A woman who has had a kidney transplant usually has more regular periods and better general health. Therefore, it is easier for her to get pregnant and have a child. However, pregnancy is not recommended for at least one year after the transplant, even with stable kidney function. In some cases, pregnancy is not recommended because of risk to the mother's life or possible loss of the transplant.

Can medicines taken by transplant patients harm an unborn child?

The amount of anti-rejection medicines is important. In the early period after a transplant, patients are on higher doses of these medicines. Once the medicines are reduced to maintenance levels, they do not seem to have negative effects on a developing baby. However, long-term side effects are still unknown. A woman transplant patient who is considering pregnancy should discuss any possible risks with her doctor.

What kind of birth control is recommended for kidney patients?

Dialysis patients who have periods or who could become pregnant should use birth control to guard against pregnancy. The doctor can recommend the type of birth control that should be used. Generally, women who have high blood pressure should not use the pill since it can raise blood pressure. Transplant patients should not use an IUD. These patients are more likely to get an infection from an IUD because the anti-rejection drugs they must take also lower the body's ability to fight infection. The diaphragm, sponge and condom are good means of birth control, especially when used with spermicidal creams, foams or jellies.

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©2014 National Kidney Foundation. All rights reserved. This material does not constitute medical advice. It is intended for informational purposes only. Please consult a physician for specific treatment recommendations.