What Your Organ Transplant Means for Your Fertility

For women undergoing an organ transplant, you’ve got a lot on your mind and birth control probably isn’t high on your list.

I recently did a study with Drs. Sally Rafie, PharmD, BCPS and Sheila Mody, MD, MPH to find out more about the education women get about birth control and which methods they are using after their transplants. This study was just published in December in the Progress in Transplantation journal. Here’s what you need to know.

Transplant Contraception Birth Control Choose Control Sophia Lai Sally Rafie

Why use birth control after a transplant?

There are three major reasons to be on birth control after an organ transplant.

  1. The transplant restores a woman’s fertility. While fertility may have been impaired before the transplant because of severe disease, it returns quickly. So women are at risk of an unplanned pregnancy if they don’t use an effective form of birth control.
  2. Getting pregnant may cause serious damage to a transplanted organ. Pregnancy is a big deal for a woman’s body and even more so for women with certain conditions, such as an organ transplant. Women with a transplanted kidney who become pregnant may cause serious damage to their kidney. Generally, it is recommended that women wait 1-2 years after their transplant surgery to become pregnant. In some cases, this can be done safely after 6 months. This is a decision that is made best upon consultation with a transplant provider.
  3. Transplant medications can cause birth defects. After an organ transplant, many medications have to be taken to keep the immune system at bay so the body doesn’t reject the organ. Some of these medications, called immunosuppressants, can increase the risk of birth defects.

Since one out of every three women who gets a transplant is of reproductive age, we wanted to find out what information they get about birth control and which methods they use.

What were the key findings?

Just to get an idea of the “average” patient we were looking at, the average age was 34 years old and the average time after transplant was 9 months.

  1. Most patients received counseling on condoms, birth control pills, and intrauterine devices (IUDs). Patients were counseled by their transplant team, which includes a transplant doctor, transplant nurse, and transplant pharmacist. However, nearly half of the patients wanted to be counseled by an Ob/Gyn doctor, who specializes in female reproductive organs.
  2. Women are not using highly effective birth control methods after their transplants.  Most women are just using condoms for birth control, which are not as effective as other methods and not reliable enough for women following an organ transplant.

What should you do about birth control and pregnancy planning if you have had a transplant?

You have the right to be informed about all your birth control options. Talk to your primary care doctor or transplant provider (doctor, nurse, or pharmacist) about your plans.

If you would like to become pregnant, your transplant provider will need to be involved in planning for changes to your health and may want to consult an Ob/Gyn doctor. If you do not want to become pregnant, ask your transplant provider to refer you to an Ob/Gyn doctor or other family planning specialist so you can find out your birth control options. You can even start these conversations before your transplant.

About the Author:  Sophia LSophia Lai Choose Control Transplant Birth Control Contraception Studyai is a fourth-year pharmacy student at the University of California San Diego Skaggs School of Pharmacy & Pharmaceutical Sciences. Upon graduating in 2015, Sophia plans to pursue additional training in a pharmacy practice residency program.

(Photo above of doctors with patient from Seattle Municipal Archives via Flickr)

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