Any success stories out there about being able to conceive even though one partner or the other receives dialysis treatments? At age 32, I’m starting to worry.
Hi Terry & Heather,
Have you read the Sexuality and Fertility module of Kidney School at http://www.kidneyschool.org? In it, we collected all of the relevant evidence about options for having children and success rates and such. Dr. Susan Hou, a national expert on pregnancy in people with kidney failure, was also kind enough to review the module.
A pregnancy in a woman who is on dialysis is considered high risk. The most recent abstract I could find by Dr. Hou says:
Semin Dial. 2003 Sep-Oct;16(5):376-8. Pregnancy in dialysis patients: where do we go from here?
Current guidelines for dialysis in pregnant women have been developed in response to occasional dialysis patients who unexpectedly become pregnant. These include prolonged dialysis times, generally 20 or more hours per week. The increased dialysis time requires careful monitoring of phosphorus and potassium which may be removed in excessive amounts. Target serum bicarbonate for a pregnant woman is 18-20 mEq/L. Patients require increased supplementation of water soluble vitamins particularly folate. Increased doses of erythropoietin are needed to meet the demands for increased red cell production occasioned by pregnancy. Hypertension is the greatest danger to the mother and extreme vigilance is required up to six weeks postpartum. Volume status is difficult to predict and can only be determined by repeated clinical assessment. Only 50% of pregnancies result in a surviving infant and in the best subgroups, no more than 75% of pregnancies are successful. Over 80% of live born infants are premature, often severely premature. The key to improving the outcome of pregnancy in dialysis patients lies in decreasing premature labor and premature rupture of membranes in the late second and early third trimester. To this end, it is important for obstetricians to recognize that the risk of prematurity in pregnant dialysis patients is as higher or higher than in any other group and that any intervention, including such measures as progesterone and oxytocin antagonists, used to prevent premature labor in other groups should be considered in dialysis patients.
Pregnancy after transplant (usually 2 years after) tends to have better outcomes. If it’s the man who is on dialysis, the sooner you try to conceive after kidney failure, the more likely you are to be successful.
Check out Module 11, the Kidney School module on sexuality and fertility. It has provides information for men and woman depending on who has kidney disease.