You might have wondered if you will be able to be a parent after receiving a transplant. Common questions can include “Can I get pregnant?”, “Can I be a father?”, “Will my meds be a problem?” or “Will there be room for a baby in there, with my transplanted kidney or liver taking up space?”
Many women who have had transplants have had successful pregnancies. Similarly, many men with transplants are fathers. As with other aspects of your life, you will need to plan a pregnancy more carefully than you would if you had not received a transplant.
Planning a pregnancy
Always talk with your health care team to plan a pregnancy. They may refer you to receive further specialized care from an obstetrician.
Most people suggest that you wait at least a year (or even longer) after transplant before getting pregnant so that you are on a lower level of immunosuppressants and can be sure your organ is working well.
Your health care team will go over your medications, your general state of health and the health of your new organ. They may adjust your medications before pregnancy to minimize the risk both to mother and baby.
The obstetrician will also make sure that your current medications are keeping your blood pressure in the normal range and that any high blood sugar levels are also kept in the normal range before pregnancy.
Medications and pregnancy
Some of the immunosuppressants and anti-infective medications you need to take after transplant can harm a baby still growing inside its mother, leading to birth defects or miscarriage. Pregnancies are most likely to be safe and successful when they are planned and closely monitored.
It is really important to use birth control if you are having sex while you are taking immunosuppressants and anti-infective medicines after transplant. Many girls and women are fertile soon after transplant, sometimes even before their first period after their surgery. In some cases, you also need to avoid pregnancy for several months after stopping a medicine.
Accidental pregnancy
Accidental pregnancies are not a good idea in any situation, but an unplanned pregnancy in a transplant patient can put both the baby and your own health at risk.
If you are having penetrative sexual intercourse (penis in vagina), you can protect yourself from an unplanned pregnancy through different options of birth control that are best for transplant patients.
If you have not planned your pregnancy and think that you are pregnant, please act as soon as possible. You can take a home pregnancy test and see your family doctor right away to confirm the result. Your doctor is not allowed to tell anyone about this, including your parents, without your permission. Also contact your transplant team so they can talk to you about your options on how to keep yourself safe.
Is pregnancy safe?
Your parents will worry about whether pregnancy is safe for you, while you may wonder if it is safe for the baby. If you are planning a family, the first thing you should ask is whether the condition that caused your original organ to fail is genetic. If it is, there is a chance that your child will have the same condition. A genetic counsellor can help you find out how the condition is inherited and the chance of your passing it on to a child. You can ask your transplant team in the adult or paediatric centre to refer you to a genetic counsellor.
Women who have transplants are a little more likely than other women to have a premature (early) baby and to have babies who are smaller than expected. But this doesn’t happen in most transplant pregnancies. Again, it is important to see an obstetrician who knows about transplant and pregnancy early, even before you get pregnant.
Transplant and fatherhood
Your transplant will not prevent you from fathering a child, but some anti-viral medications may decrease the number and quality of your sperm. Talk to your transplant team if you need advice. Just like with women, the condition that led to your transplant may be something that you could pass on to your child through your genes. Talking with a genetic counsellor can help you understand the risks of passing on your condition.
Breastfeeding after a transplant
Small amounts of immunosuppressant medicine get into breast milk. For this reason, many doctors have advised against breast feeding. If you really want to breastfeed, talk with an expert about your options.
