Contraception and Fertility Awareness Among Women With Solid Organ Transplants

French, Valerie A. MD; Davis, John S. PhD; Sayles, Harlan S. MS; Wu, Serena S. MD

Obstetrics & Gynecology:
doi: 10.1097/AOG.0b013e3182a5eda9
Original Research
Abstract

OBJECTIVE: To assess the contraception and fertility counseling provided to women with solid organ transplants.

METHODS: A telephone survey of 309 women aged 19–49 years who had received a solid organ transplant at the University of Nebraska Medical Center was performed. Of the 309 eligible women, 183 responded. Patients were asked 19 questions regarding pretransplant and posttransplant fertility awareness and contraception counseling. Data were summarized using descriptive statistics.

RESULTS: Patients had undergone a variety of solid organ transplantations: 40% kidney (n=73); 32% liver (n=59); 6% pancreas (n=11); 5% heart (n=9); 3% intestine (n=5); and 14% multiple organs (n=26). Before their transplantations, 79 women (44%) reported they were not aware that a woman could become pregnant after transplantation. Only 66 women aged 13 and older at the time of transplantation reported that a health care provider discussed contraception before transplantation. Approximately half of women surveyed were using a method of contraception. Oral contraceptive pills were the most commonly recommended method. Twenty-two of the 31 pregnancies after organ transplantation were planned, which is higher than that of the general population.

CONCLUSION: Few women with transplants are educated regarding the effect of organ transplantation on fertility and are not routinely counseled about contraception or the potential for posttransplant pregnancy. Health care providers should incorporate contraceptive and fertility counseling as part of routine care for women with solid organ transplants.

LEVEL OF EVIDENCE: II

In Brief

Women with solid organ transplants are poorly educated regarding the effect of transplantation on fertility and are not routinely counseled about contraception.

Author Information

Olson Center for Women's Heath, Department of Obstetrics and Gynecology, and the College of Public Health, University of Nebraska Medical Center, and the Omaha VA Medical Center, Omaha, Nebraska; and the Department of Obstetrics and Gynecology, Good Samaritan Hospital Medical Center, West Islip, New York.

Corresponding author: Valerie French, MD, Department of Obstetrics, Gynecology and Reproductive Sciences, 1001 Potrero Avenue, Ward 6D, San Francisco, CA 94110; e-mail valerie.a.french@gmail.com.

Funded by the American College of Obstetricians and Gynecologists/Bayer Healthcare Contraceptive Counseling Award and supported by the Olson Center for Women's Health and VA Medical Center.

This work was supported in part by Health Resources and Services Administration contract 234-2005-37011C. The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.

Financial Disclosure The authors did not report any potential conflicts of interest.

The authors thank Dr. Alan Langnas at the Nebraska Medical Center, Section of Transplant Surgery, for his assistance with project development and participant recruitment.

© 2013 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.