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Open Access 24-06-2023 | Chronic Kidney Disease | Position papers and Guidelines

Chronic kidney disease, female infertility, and medically assisted reproduction: a best practice position statement by the Kidney and Pregnancy Group of the Italian Society of Nephrology

Authors: Rossella Attini, Gianfranca Cabiddu, Francesca Ciabatti, Benedetta Montersino, Andrea Roberto Carosso, Giuseppe Gernone, Linda Gammaro, Gabriella Moroni, Massimo Torreggiani, Bianca Masturzo, Domenico Santoro, Alberto Revelli, Giorgina Barbara Piccoli, On behalf of the Italian Society of Nephrology’s Project Group on Kidney and Pregnancy

Published in: Journal of Nephrology | Issue 5/2023

Abstract

Fertility is known to be impaired more frequently in patients with chronic kidney disease than in the general population. A significant proportion of chronic kidney disease patients may therefore need Medically Assisted Reproduction. The paucity of information about medically assisted reproduction for chronic kidney disease patients complicates counselling for both nephrologists and gynaecologists, specifically for patients with advanced chronic kidney disease and those on dialysis or with a transplanted kidney. It is in this context that the Project Group on Kidney and Pregnancy of the Italian Society of Nephrology has drawn up these best practice guidelines, merging a literature review, nephrology expertise and the experience of obstetricians and gynaecologists involved in medically assisted reproduction. Although all medically assisted reproduction techniques can be used for chronic kidney disease patients, caution is warranted. Inducing a twin pregnancy should be avoided; the risk of bleeding, thrombosis and infection should be considered, especially in some categories of patients. In most cases, controlled ovarian stimulation is needed to obtain an adequate number of oocytes for medically assisted reproduction. Women with chronic kidney disease are at high risk of kidney damage in case of severe ovarian hyperstimulation syndrome, and great caution should be exercised so that it is avoided. The higher risks associated with the hypertensive disorders of pregnancy, and the consequent risk of chronic kidney disease progression, should likewise be considered if egg donation is chosen. Oocyte cryopreservation should be considered for patients with autoimmune diseases who need cytotoxic treatment. In summary, medically assisted reproduction is an option for chronic kidney disease patients, but the study group strongly advises extensive personalised counselling with a multidisciplinary healthcare team and close monitoring during the chosen medically assisted reproduction procedure and throughout the subsequent pregnancy.

Graphical abstract

Vander Borght M, Wyns C (2018) Fertility and infertility: definition and epidemiology. Clin Biochem 62:2–10. https://doi.org/10.1016/j.clinbiochem.2018.03.012CrossRefPubMed

Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel S, Stevens GA (2012) National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys. PLoS Med 9(12):e1001356. https://doi.org/10.1371/journal.pmed.1001356CrossRefPubMedPubMedCentral

Dumanski SM, Ahmed SB (2019) Fertility and reproductive care in chronic kidney disease. J Nephrol 32(1):39–50. https://doi.org/10.1007/s40620-018-00569-9CrossRefPubMed

Piccoli GB, Zakharova E, Attini R, Ibarra Hernandez M, Orozco Guillien A, Alrukhaimi M et al (2018) Pregnancy in chronic kidney disease: need for higher awareness a pragmatic review focused on what could be improved in the different CKD stages and phases. J Clin Med. https://doi.org/10.3390/jcm7110415CrossRefPubMedPubMedCentral

Chang DH, Dumanski SM, Ahmed SB (2022) Female reproductive and gynecologic considerations in chronic kidney disease: adolescence and young adulthood. Kidney Int Rep 7(2):152–164. https://doi.org/10.1016/j.ekir.2021.11.003CrossRefPubMed

Stoumpos S, Lees J, Welsh P, Hund M, Geddes CC, Nelson SM et al (2018) The utility of anti-Mullerian hormone in women with chronic kidney disease, on haemodialysis and after kidney transplantation. Reprod Biomed Online 36(2):219–226. https://doi.org/10.1016/j.rbmo.2017.11.003CrossRefPubMed

Zegers-Hochschild F, Adamson GD, Dyer S, Racowsky C, de Mouzon J, Sokol R et al (2017) The International Glossary on Infertility and Fertility Care, 2017. Fertil Steril 108(3):393–406. https://doi.org/10.1016/j.fertnstert.2017.06.005CrossRefPubMed

Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K et al (2009) International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009. Fertil Steril 92(5):1520–1524. https://doi.org/10.1016/j.fertnstert.2009.09.009CrossRefPubMed

Jaar BG, Khatib R, Plantinga L, Boulware LE, Powe NR (2008) Principles of screening for chronic kidney disease. Clin J Am Soc Nephrol 3(2):601–609. https://doi.org/10.2215/CJN.02540607CrossRefPubMedPubMedCentral

10.

Brown MA, Holt JL, Mangos GJ, Murray N, Curtis J, Homer C (2005) Microscopic hematuria in pregnancy: relevance to pregnancy outcome. Am J Kidney Dis 45(4):667–673. https://doi.org/10.1053/j.ajkd.2004.12.023CrossRefPubMed

11.

Piccoli GB, Chatrenet A, Cataldo M, Torreggiani M, Attini R, Masturzo B et al (2022) Adding creatinine to routine pregnancy tests: a decision tree for calculating the cost of identifying patients with CKD in pregnancy. Nephrol Dial Transplant. https://doi.org/10.1093/ndt/gfac051CrossRefPubMedPubMedCentral

12.

Webster P, Lightstone L, McKay DB, Josephson MA (2017) Pregnancy in chronic kidney disease and kidney transplantation. Kidney Int 91(5):1047–1056. https://doi.org/10.1016/j.kint.2016.10.045CrossRefPubMed

13.

Cabiddu G, Mannucci C, Fois A, Maxia S, Chatrenet A, Osadolor S et al (2022) Pre-eclampsia is a valuable opportunity to diagnose chronic kidney disease: a multicentre study. Nephrol Dial Transplant 37(8):1488–1498. https://doi.org/10.1093/ndt/gfab225CrossRefPubMed

14.

Kattah AG, Scantlebury DC, Agarwal S, Mielke MM, Rocca WA, Weaver AL et al (2017) Preeclampsia and ESRD: the role of shared risk factors. Am J Kidney Dis 69(4):498–505. https://doi.org/10.1053/j.ajkd.2016.07.034CrossRefPubMed

15.

Hewawasam E, Davies CE, Li Z, Clayton P, Sullivan E, McDonald SP et al (2022) Determinants of perinatal outcomes in dialyzed and transplanted women in Australia. Kidney Int Rep 7(6):1318–1331. https://doi.org/10.1016/j.ekir.2022.03.015CrossRefPubMedPubMedCentral

16.

Piccoli GB, Cabiddu G, Daidone G, Guzzo G, Maxia S, Ciniglio I et al (2014) The children of dialysis: live-born babies from on-dialysis mothers in Italy–an epidemiological perspective comparing dialysis, kidney transplantation and the overall population. Nephrol Dial Transplant 29(8):1578–1586. https://doi.org/10.1093/ndt/gfu092CrossRefPubMed

17.

Shah S, Christianson AL, Meganathan K, Leonard AC, Schauer DP, Thakar CV (2019) Racial differences and factors associated with pregnancy in ESKD patients on dialysis in the United States. J Am Soc Nephrol 30(12):2437–2448. https://doi.org/10.1681/ASN.2019030234CrossRefPubMedPubMedCentral

18.

Hladunewich MA, Hou S, Odutayo A, Cornelis T, Pierratos A, Goldstein M et al (2014) Intensive hemodialysis associates with improved pregnancy outcomes: a Canadian and United States cohort comparison. J Am Soc Nephrol 25(5):1103–1109. https://doi.org/10.1681/ASN.2013080825CrossRefPubMedPubMedCentral

19.

Piccoli GB, Cabiddu G, Attini R, Gerbino M, Todeschini P, Perrino ML et al (2016) Pregnancy outcomes after kidney graft in Italy: are the changes over time the result of different therapies or of different policies? A nationwide survey (1978–2013). Nephrol Dial Transplant 31(11):1957–1965. https://doi.org/10.1093/ndt/gfw232CrossRefPubMed

20.

Gosselink ME, van Buren MC, Kooiman J, Groen H, Ganzevoort W, van Hamersvelt HW et al (2022) A nationwide Dutch cohort study shows relatively good pregnancy outcomes after kidney transplantation and finds risk factors for adverse outcomes. Kidney Int 102(4):866–875. https://doi.org/10.1016/j.kint.2022.06.006CrossRefPubMed

21.

Ponticelli C, Zaina B, Moroni G (2021) Planned pregnancy in kidney transplantation. A calculated risk. J Pers Med. https://doi.org/10.3390/jpm11100956CrossRefPubMedPubMedCentral

22.

Coscia LA, Armenti DP, King RW, Sifontis NM, Constantinescu S, Moritz MJ (2015) Update on the teratogenicity of maternal mycophenolate mofetil. J Pediatr Genet 4(2):42–55. https://doi.org/10.1055/s-0035-1556743CrossRefPubMedPubMedCentral

23.

Piccoli GB, Conijn A, Consiglio V, Vasario E, Attini R, Deagostini MC et al (2010) Pregnancy in dialysis patients: is the evidence strong enough to lead us to change our counseling policy? Clin J Am Soc Nephrol 5(1):62–71. https://doi.org/10.2215/CJN.05660809CrossRefPubMedPubMedCentral

24.

(1975) Pregnancy and renal disease. Lancet 2(7939):801-802

25.

Mc Laughlin L, Neukirchinger B, Noyes J (2022) Interventions for and experiences of shared decision-making underpinning reproductive health, family planning options and pregnancy for women with or at high risk of kidney disease: a systematic review and qualitative framework synthesis. BMJ Open 12(8):e062392. https://doi.org/10.1136/bmjopen-2022-062392CrossRefPubMedPubMedCentral

26.

van Buren MC, Beck DK, Lely AT, van de Wetering J, Massey EK (2021) EXPloring attitudes and factors influencing reproductive Choices in kidney Transplant patients (The EXPECT-study). Clin Transplant 35(12):e14473. https://doi.org/10.1111/ctr.14473CrossRefPubMedPubMedCentral

27.

Tong A, Brown MA, Winkelmayer WC, Craig JC, Jesudason S (2015) Perspectives on pregnancy in women With CKD: a semistructured interview study. Am J Kidney Dis 66(6):951–961. https://doi.org/10.1053/j.ajkd.2015.08.023CrossRefPubMed

28.

Gillon R (1985) “Primum non nocere” and the principle of non-maleficence. Br Med J (Clin Res Ed) 291(6488):130–131. https://doi.org/10.1136/bmj.291.6488.130CrossRefPubMed

29.

Gillon R (1994) Medical ethics: four principles plus attention to scope. BMJ 309(6948):184–188. https://doi.org/10.1136/bmj.309.6948.184CrossRefPubMedPubMedCentral

30.

Genuis QIT (2021) A genealogy of autonomy: freedom, paternalism, and the future of the doctor-patient relationship. J Med Philos 46(3):330–349. https://doi.org/10.1093/jmp/jhab004CrossRefPubMedPubMedCentral

31.

Doody KJ (2021) Infertility treatment now and in the future. Obstet Gynecol Clin North Am 48(4):801–812. https://doi.org/10.1016/j.ogc.2021.07.005CrossRefPubMed

32.

Mellagi APG, Will KJ, Quirino M, Bustamante-Filho IC, Ulguim RDR, Bortolozzo FP (2022) Update on artificial insemination: semen, techniques, and sow fertility. Mol Reprod Dev. https://doi.org/10.1002/mrd.23643CrossRefPubMed

33.

Doroftei B, Ilie OD, Anton N, Armeanu T, Ilea C (2022) A mini-review regarding the clinical outcomes of in vitro fertilization (IVF) following pre-implantation genetic testing (PGT)-next generation sequencing (NGS) approach. Diagnostics (Basel). https://doi.org/10.3390/diagnostics12081911CrossRefPubMed

34.

Snoek R, Stokman MF, Lichtenbelt KD, van Tilborg TC, Simcox CE, Paulussen ADC et al (2020) Preimplantation genetic testing for monogenic kidney disease. Clin J Am Soc Nephrol 15(9):1279–1286. https://doi.org/10.2215/CJN.03550320CrossRefPubMedPubMedCentral

35.

Murphy EL, Droher ML, DiMaio MS, Dahl NK (2018) Preimplantation genetic diagnosis counseling in autosomal dominant polycystic kidney disease. Am J Kidney Dis 72(6):866–872. https://doi.org/10.1053/j.ajkd.2018.01.048CrossRefPubMed

36.

Mir Pardo P, Martinez-Conejero JA, Martin J, Simon C, Cervero A (2020) Combined preimplantation genetic testing for autosomal dominant polycystic kidney disease: consequences for embryos available for transfer. Genes (Basel). https://doi.org/10.3390/genes11060692CrossRefPubMed

37.

Kalinderis M, Kalinderi K, Srivastava G, Homburg R (2021) When should we freeze embryos? Current data for fresh and frozen embryo replacement IVF cycles. Reprod Sci 28(11):3061–3072. https://doi.org/10.1007/s43032-021-00628-wCrossRefPubMed

38.

Rivera JCH, Perez Lopez MJ, Corzo Bermudez CH, Garcia Covarrubias L, Bermudez Aceves LA, Chucuan Castillo CA et al (2019) Delayed initiation of hemodialysis in pregnant women with chronic kidney disease: logistical problems impact clinical outcomes. An experience from an emerging country. J Clin Med. https://doi.org/10.3390/jcm8040475CrossRefPubMedPubMedCentral

39.

Lemardeley G, Pirrello O, Dieterle S, Zebina A, Astrugue C, Jonveaux P et al (2021) Overview of hospitalizations in women undergoing oocyte retrieval for ART in the French national health data system. Hum Reprod 36(10):2769–2781. https://doi.org/10.1093/humrep/deab147CrossRefPubMed

40.

El-Shawarby S, Margara R, Trew G, Lavery S (2004) A review of complications following transvaginal oocyte retrieval for in-vitro fertilization. Hum Fertil (Camb) 7(2):127–133. https://doi.org/10.1080/14647270410001699081CrossRefPubMed

41.

Achermann APP, Pereira TA, Esteves SC (2021) Microdissection testicular sperm extraction (micro-TESE) in men with infertility due to nonobstructive azoospermia: summary of current literature. Int Urol Nephrol 53(11):2193–2210. https://doi.org/10.1007/s11255-021-02979-4CrossRefPubMed

42.

Gullo G, Cucinella G, Perino A, Gullo D, Segreto D, Lagana AS et al (2021) The gender gap in the diagnostic-therapeutic journey of the infertile couple. Int J Environ Res Public Health. https://doi.org/10.3390/ijerph18126184CrossRefPubMedPubMedCentral

43.

Pavan-Jukic D, Stubljar D, Jukic T, Starc A (2020) Predictive factors for sperm retrieval from males with azoospermia who are eligible for testicular sperm extraction (TESE). Syst Biol Reprod Med 66(1):70–75. https://doi.org/10.1080/19396368.2019.1680764CrossRefPubMed

44.

Chambers GM, Keller E, Choi S, Khalaf Y, Crawford S, Botha W et al (2020) Funding and public reporting strategies for reducing multiple pregnancy from fertility treatments. Fertil Steril 114(4):715–721. https://doi.org/10.1016/j.fertnstert.2020.08.1405CrossRefPubMed

45.

European IVFmCddftESoHR, Embryology, Wyns C, Bergh C, Calhaz-Jorge C, De Geyter C, et al (2020) ART in Europe 2016: results generated from European registries by ESHRE. Hum Reprod Open 2020(3):hoaa032. https://doi.org/10.1093/hropen/hoaa032

46.

Massin N, Cedrin-Durnerin I, Hugues JN (2004) Intrauterine insemination: spontaneous or medically-assisted ovulation? Gynecol Obstet Fertil 32(10):898–903. https://doi.org/10.1016/j.gyobfe.2004.07.015CrossRefPubMed

47.

Sunkara SK, LaMarca A, Polyzos NP, Seed PT, Khalaf Y (2016) Live birth and perinatal outcomes following stimulated and unstimulated IVF: analysis of over two decades of a nationwide data. Hum Reprod 31(10):2261–2267. https://doi.org/10.1093/humrep/dew184CrossRefPubMed

48.

Allegra A, Marino A, Volpes A, Coffaro F, Scaglione P, Gullo S et al (2017) A randomized controlled trial investigating the use of a predictive nomogram for the selection of the FSH starting dose in IVF/ICSI cycles. Reprod Biomed Online 34(4):429–438. https://doi.org/10.1016/j.rbmo.2017.01.012CrossRefPubMed

49.

Ebid A, Motaleb SMA, Mostafa MI, Soliman MMA (2021) Novel nomogram-based integrated gonadotropin therapy individualization in in vitro fertilization/intracytoplasmic sperm injection: a modeling approach. Clin Exp Reprod Med 48(2):163–173. https://doi.org/10.5653/cerm.2020.03909CrossRefPubMedPubMedCentral

50.

Marino A, Gullo S, Sammartano F, Volpes A, Allegra A (2022) Algorithm-based individualization methodology of the starting gonadotropin dose in IVF/ICSI and the freeze-all strategy prevent OHSS equally in normal responders: a systematic review and network meta-analysis of the evidence. J Assist Reprod Genet 39(7):1583–1601. https://doi.org/10.1007/s10815-022-02503-2CrossRefPubMedPubMedCentral

51.

Broekmans FJ, de Ziegler D, Howles CM, Gougeon A, Trew G, Olivennes F (2010) The antral follicle count: practical recommendations for better standardization. Fertil Steril 94(3):1044–1051. https://doi.org/10.1016/j.fertnstert.2009.04.040CrossRefPubMed

52.

La Marca A, Sunkara SK (2014) Individualization of controlled ovarian stimulation in IVF using ovarian reserve markers: from theory to practice. Hum Reprod Update 20(1):124–140. https://doi.org/10.1093/humupd/dmt037CrossRefPubMed

53.

Bergandi L, Canosa S, Carosso AR, Paschero C, Gennarelli G, Silvagno F et al (2020) Human recombinant FSH and its biosimilars: clinical efficacy, safety, and cost-effectiveness in controlled ovarian stimulation for in vitro fertilization. Pharmaceuticals (Basel). https://doi.org/10.3390/ph13070136CrossRefPubMedPubMedCentral

54.

Loutradis D, Drakakis P, Vlismas A, Antsaklis A (2009) Corifollitropin alfa, a long-acting follicle-stimulating hormone agonist for the treatment of infertility. Curr Opin Investig Drugs 10(4):372–380PubMed

55.

Abou Arkoub R, Xiao CW, Claman P, Clark EG (2019) Acute kidney injury due to ovarian hyperstimulation syndrome. Am J Kidney Dis 73(3):416–420. https://doi.org/10.1053/j.ajkd.2018.10.010CrossRefPubMed

56.

Selter J, Wen T, Palmerola KL, Friedman AM, Williams Z, Forman EJ (2019) Life-threatening complications among women with severe ovarian hyperstimulation syndrome. Am J Obstet Gynecol 220(6):575e1-e11. https://doi.org/10.1016/j.ajog.2019.02.009CrossRef

57.

Sammaritano LR, Bermas BL, Chakravarty EE, Chambers C, Clowse MEB, Lockshin MD et al (2020) 2020 American College of Rheumatology guideline for the management of reproductive health in rheumatic and musculoskeletal diseases. Arthritis Care Res (Hoboken) 72(4):461–488. https://doi.org/10.1002/acr.24130CrossRefPubMed

58.

Andreoli L, Bertsias GK, Agmon-Levin N, Brown S, Cervera R, Costedoat-Chalumeau N et al (2017) EULAR recommendations for women’s health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome. Ann Rheum Dis 76(3):476–485. https://doi.org/10.1136/annrheumdis-2016-209770CrossRefPubMed

59.

Haas J, Casper RF (2017) In vitro fertilization treatments with the use of clomiphene citrate or letrozole. Fertil Steril 108(4):568–571. https://doi.org/10.1016/j.fertnstert.2017.08.017CrossRefPubMed

60.

Elizur SE, Chian RC, Pineau CA, Son WY, Holzer HE, Huang JY et al (2008) Fertility preservation treatment for young women with autoimmune diseases facing treatment with gonadotoxic agents. Rheumatology (Oxford) 47(10):1506–1509. https://doi.org/10.1093/rheumatology/ken293CrossRefPubMed

61.

Ragab A, Barakat R, Ragheb M, State O, Badawy A (2012) Subfertility treatment in women with systemic lupus erythematosus. J Obstet Gynaecol 32(6):569–571. https://doi.org/10.3109/01443615.2012.693986CrossRefPubMed

62.

Guballa N, Sammaritano L, Schwartzman S, Buyon J, Lockshin MD (2000) Ovulation induction and in vitro fertilization in systemic lupus erythematosus and antiphospholipid syndrome. Arthritis Rheum 43(3):550–556. https://doi.org/10.1002/1529-0131(200003)43:3%3c550::AID-ANR10%3e3.0.CO;2-YCrossRefPubMed

63.

Huong DL, Wechsler B, Vauthier-Brouzes D, Duhaut P, Costedoat N, Lefebvre G et al (2002) Importance of planning ovulation induction therapy in systemic lupus erythematosus and antiphospholipid syndrome: a single center retrospective study of 21 cases and 114 cycles. Semin Arthritis Rheum 32(3):174–188. https://doi.org/10.1053/sarh.2002.37212CrossRefPubMed

64.

Orquevaux P, Masseau A, Le Guern V, Gayet V, Vauthier D, Guettrot-Imbert G et al (2017) In vitro fertilization in 37 women with systemic lupus erythematosus or antiphospholipid syndrome: a series of 97 procedures. J Rheumatol 44(5):613–618. https://doi.org/10.3899/jrheum.160462CrossRefPubMed

65.

Gastanaga-Holguera T, Calvo M, Gomez-Irwin L, Gesto IC, Gonzalez-Gonzalez V, Vidaurreta M (2021) Successful pregnancy and follow-up after in vitro fertilization of a kidney transplant patient with systemic lupus erythematosus, primary biliary cholangitis, and hypothyroidism. JBRA Assist Reprod 25(4):657–660. https://doi.org/10.5935/1518-0557.20210052CrossRefPubMedPubMedCentral

66.

Piccoli GB, Arduino S, Attini R, Parisi S, Fassio F, Biolcati M et al (2013) Multiple pregnancies in CKD patients: an explosive mix. Clin J Am Soc Nephrol 8(1):41–50. https://doi.org/10.2215/CJN.02550312CrossRefPubMed

67.

Busnelli A, Dallagiovanna C, Reschini M, Paffoni A, Fedele L, Somigliana E (2019) Risk factors for monozygotic twinning after in vitro fertilization: a systematic review and meta-analysis. Fertil Steril 111(2):302–317. https://doi.org/10.1016/j.fertnstert.2018.10.025CrossRefPubMed

68.

Schultz C, Huberlant S, Letouzey V, Moranne O (2022) Hemoperitoneum complicating an oocyte puncture in a chronic hemodialysis patient. J Nephrol 35(9):2433–2435. https://doi.org/10.1007/s40620-022-01270-8CrossRefPubMed

69.

Timmons D, Montrief T, Koyfman A, Long B (2019) Ovarian hyperstimulation syndrome: a review for emergency clinicians. Am J Emerg Med 37(8):1577–1584. https://doi.org/10.1016/j.ajem.2019.05.018CrossRefPubMed

70.

Delvigne A, Rozenberg S (2002) Epidemiology and prevention of ovarian hyperstimulation syndrome (OHSS): a review. Hum Reprod Update 8(6):559–577. https://doi.org/10.1093/humupd/8.6.559CrossRefPubMed

71.

Siddall E, Khatri M, Radhakrishnan J (2017) Capillary leak syndrome: etiologies, pathophysiology, and management. Kidney Int 92(1):37–46. https://doi.org/10.1016/j.kint.2016.11.029CrossRefPubMed

72.

Aboulghar MA, Mansour RT (2003) Ovarian hyperstimulation syndrome: classifications and critical analysis of preventive measures. Hum Reprod Update 9(3):275–289. https://doi.org/10.1093/humupd/dmg018CrossRefPubMed

73.

Khalaf Y, Elkington N, Anderson H, Taylor A, Braude P (2000) Ovarian hyperstimulation syndrome and its effect on renal function in a renal transplant patient undergoing IVF treatment: case report. Hum Reprod 15(6):1275–1277. https://doi.org/10.1093/humrep/15.6.1275CrossRefPubMed

74.

Zheng HH, Song Y, Wu JY (2016) Critical ovarian hyperstimulation syndrome after in vitro fertilization treatment in a renal transplant recipient: a case report. Transplant Proc 48(1):267–270. https://doi.org/10.1016/j.transproceed.2016.01.008CrossRefPubMed

75.

Pereira N, Lekovich JP, Kligman I, Rosenwaks Z (2017) Severe ovarian hyperstimulation syndrome after combined GnRH-agonist and low-dose human chorionic gonadotropin trigger in a patient with a single kidney. Gynecol Endocrinol 33(8):593–597. https://doi.org/10.1080/09513590.2017.1318372CrossRefPubMed

76.

Kobak S, Hacivelioglu S, Gungor S (2014) Scleroderma renal crisis and ovarian hyperstimulation syndrome related to the use of clomiphene in a patient with scleroderma. Reumatol Clin 10(1):51–53. https://doi.org/10.1016/j.reuma.2012.11.003CrossRefPubMed

77.

Mourad S, Brown J, Farquhar C (2017) Interventions for the prevention of OHSS in ART cycles: an overview of Cochrane reviews. Cochrane Database Syst Rev 1(1):Cd012103. https://doi.org/10.1002/14651858.CD012103.pub2CrossRefPubMed

78.

van der Hoorn ML, Lashley EE, Bianchi DW, Claas FH, Schonkeren CM, Scherjon SA (2010) Clinical and immunologic aspects of egg donation pregnancies: a systematic review. Hum Reprod Update 16(6):704–712. https://doi.org/10.1093/humupd/dmq017CrossRefPubMed

79.

Ledingham D, Plant M, Mustafa F, Patil B (2020) Preserving fertility: using cyclophosphamide and other cytotoxics in young people. Pract Neurol 20(2):148–153. https://doi.org/10.1136/practneurol-2019-002247CrossRefPubMed

80.

Gotestam Skorpen C, Hoeltzenbein M, Tincani A, Fischer-Betz R, Elefant E, Chambers C et al (2016) The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Ann Rheum Dis 75(5):795–810. https://doi.org/10.1136/annrheumdis-2015-208840CrossRefPubMed

81.

Blumenfeld Z, Evron A (2015) Preserving fertility when choosing chemotherapy regimens—the role of gonadotropin-releasing hormone agonists. Expert Opin Pharmacother 16(7):1009–1020. https://doi.org/10.1517/14656566.2015.1031654CrossRefPubMed

82.

Valsamakis G, Valtetsiotis K, Charmandari E, Lambrinoudaki I, Vlahos NF (2022) GnRH analogues as a co-treatment to therapy in women of reproductive age with cancer and fertility preservation. Int J Mol Sci. https://doi.org/10.3390/ijms23042287CrossRefPubMedPubMedCentral

83.

Del Mastro L, Ceppi M, Poggio F, Bighin C, Peccatori F, Demeestere I et al (2014) Gonadotropin-releasing hormone analogues for the prevention of chemotherapy-induced premature ovarian failure in cancer women: systematic review and meta-analysis of randomized trials. Cancer Treat Rev 40(5):675–683. https://doi.org/10.1016/j.ctrv.2013.12.001CrossRefPubMed

84.

Donnez J, Dolmans MM (2017) Fertility preservation in women. N Engl J Med 377(17):1657–1665. https://doi.org/10.1056/NEJMra1614676CrossRefPubMed

85.

Baldwin K, Gray D, Hudson N (2019) On ice: the impact of vitrification on the use of eggs in fertility treatment. Emerg Top Life Sci 3(6):713–717. https://doi.org/10.1042/ETLS20190062CrossRefPubMed

86.

Walker Z, Lanes A, Ginsburg E (2022) Oocyte cryopreservation review: outcomes of medical oocyte cryopreservation and planned oocyte cryopreservation. Reprod Biol Endocrinol 20(1):10. https://doi.org/10.1186/s12958-021-00884-0CrossRefPubMedPubMedCentral

87.

Noyes N, Porcu E, Borini A (2009) Over 900 oocyte cryopreservation babies born with no apparent increase in congenital anomalies. Reprod Biomed Online 18(6):769–776. https://doi.org/10.1016/s1472-6483(10)60025-9CrossRefPubMed

88.

Revelli A, Molinari E, Salvagno F, Delle Piane L, Dolfin E, Ochetti S (2012) Oocyte cryostorage to preserve fertility in oncological patients. Obstet Gynecol Int. 2012:525896. https://doi.org/10.1155/2012/525896CrossRefPubMedPubMedCentral

89.

Poirot C, Brugieres L, Yakouben K, Prades-Borio M, Marzouk F, de Lambert G et al (2019) Ovarian tissue cryopreservation for fertility preservation in 418 girls and adolescents up to 15 years of age facing highly gonadotoxic treatment. Twenty years of experience at a single center. Acta Obstet Gynecol Scand 98(5):630–637. https://doi.org/10.1111/aogs.13616CrossRefPubMed

90.

Vukovic P, Kasum M, Oreskovic D, Cehic E, Raguz J, Elezaj S et al (2019) Importance of ovarian tissue cryopreservation in fertility preservation and anti-aging treatment. Gynecol Endocrinol 35(11):919–923. https://doi.org/10.1080/09513590.2019.1611763CrossRefPubMed

91.

Jesudason S, Williamson A, Huuskes B, Hewawasam E (2022) Parenthood with kidney failure: answering questions patients ask about pregnancy. Kidney Int Rep 7(7):1477–1492. https://doi.org/10.1016/j.ekir.2022.04.081CrossRefPubMedPubMedCentral

92.

Iltis AS, Mehta M, Sawinski D (2021) Ignorance is not bliss: the case for comprehensive reproductive counseling for women with chronic kidney disease. HEC Forum. https://doi.org/10.1007/s10730-021-09463-7CrossRefPubMed

93.

Cabiddu G, Spotti D, Gernone G, Santoro D, Moroni G, Gregorini G et al (2018) A best-practice position statement on pregnancy after kidney transplantation: focusing on the unsolved questions. The Kidney and Pregnancy Study Group of the Italian Society of Nephrology. J Nephrol. 31(5):665–81. https://doi.org/10.1007/s40620-018-0499-xCrossRefPubMedPubMedCentral

94.

Wiles K, Webster P, Seed PT, Bennett-Richards K, Bramham K, Brunskill N et al (2021) The impact of chronic kidney disease Stages 3–5 on pregnancy outcomes. Nephrol Dial Transplant 36(11):2008–2017. https://doi.org/10.1093/ndt/gfaa247CrossRefPubMed

95.

Snoek R, van der Graaf R, Meinderts JR, van Reekum F, Bloemenkamp KWM, Knoers N et al (2020) Pregnancy in advanced kidney disease: clinical practice considerations on a challenging combination. Nephron 144(4):185–189. https://doi.org/10.1159/000505781CrossRefPubMed

96.

Cabiddu G, Castellino S, Gernone G, Santoro D, Giacchino F, Credendino O et al (2015) Best practices on pregnancy on dialysis: the Italian Study Group on Kidney and Pregnancy. J Nephrol 28(3):279–288. https://doi.org/10.1007/s40620-015-0191-3CrossRefPubMed

97.

Cabiddu G, Castellino S, Gernone G, Santoro D, Moroni G, Giannattasio M et al (2016) A best practice position statement on pregnancy in chronic kidney disease: the Italian Study Group on Kidney and Pregnancy. J Nephrol 29(3):277–303. https://doi.org/10.1007/s40620-016-0285-6CrossRefPubMedPubMedCentral

Title: Chronic kidney disease, female infertility, and medically assisted reproduction: a best practice position statement by the Kidney and Pregnancy Group of the Italian Society of Nephrology
Authors: Rossella Attini
Gianfranca Cabiddu
Francesca Ciabatti
Benedetta Montersino
Andrea Roberto Carosso
Giuseppe Gernone
Linda Gammaro
Gabriella Moroni
Massimo Torreggiani
Bianca Masturzo
Domenico Santoro
Alberto Revelli
Giorgina Barbara Piccoli
On behalf of the Italian Society of Nephrology’s Project Group on Kidney and Pregnancy
Publication date: 24-06-2023
Publisher: Springer International Publishing
Keywords: Chronic Kidney Disease
Ovarian Hyperstimulation Syndrome
Infertility
Infertility
In Vitro Fertilisation
In Vitro Fertilisation
Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Fertility
Assisted Reproduction
Published in: Journal of Nephrology / Issue 5/2023
Print ISSN: 1121-8428
Electronic ISSN: 1724-6059
DOI: https://doi.org/10.1007/s40620-023-01670-4

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