Contraceptive use in female recipients of a solid-organ transplant

Abstract

Context: Women of reproductive age account for more than one-third of all solid-organ transplant recipients and are advised against becoming pregnant for 1 to 2 years after their surgeries. The risks posed to the woman, the transplanted organ, and the fetus underscore the importance of systems to ensure that patients receive counseling on family planning, including return to fertility, contraceptive use, and when pregnancy can be safely considered, and highly effective methods of contraception.

Objective: To investigate use of contraceptives among women after solid-organ transplant and to identify opportunities to improve care.

Design: A cross-sectional survey study.

Setting: An urban academic medical center.

Patients: Women 18 to 50 years old who have received a kidney, pancreas, and/or liver transplant within the past 1 to 24 months.

Intervention: Participants completed self-administered questionnaires regarding their menstrual pattern, pregnancy history, contraceptive use before and after transplant, and counseling on family planning issues.

Main outcome measures: Contraceptive use.

Results: The most common contraceptive method used in both the year preceding transplant and the year after transplant was condoms. Participants desired more counseling on highly effective contraceptive methods, such as intrauterine devices. Participants would like to receive contraceptive counseling from an obstetrician/gynecologist or transplant care team provider.

Conclusion: Female recipients of solid-organ transplants want more counseling on highly effective methods of contraception.