Infertility and ART after transplantation

• The risk of premature reproductive failure in organ transplantation patients.
• Female and male subfertility pathophysiology of non-solid and solid organ transplants.
• Review on the most up-to-date ART options in fertility preservation and treatment.
• Assessment of specific ART complications in organ transplantation patients.

Organ transplantation (OT) has improved the long-term survival of patients facing specific organ failure and has refocused management to a chronic condition, with emphasis on enhancing life quality, including respecting a patient's autonomy to have children. Transplant patients are often faced with subfertility, frequently a consequence of gonadotoxic medical therapy. For some patients, successful OT management, reproductive conservation measures and the use of assisted reproductive technologies (ART) may help preserve fertility. There is a growing literature on the use of ART in these patients. The main objective of ART in OT recipients is attaining a healthy pregnancy, while minimizing potential complications that would jeopardize both the maternal health status and offspring. The purpose of this article is to address the distinctive medical, ethical and psychosocial concerns surrounding the fertility management of OT recipients.