Sexual Function in Chronic Kidney Disease

Pregnancy after Kidney Transplantation

“…Male infertility during ESRD is associated with low testosterone; high FSH, LH, and prolactin levels; and high estrogen levels, resulting in impotence as well as spermatogenic abnormalities (8,16). The testis is marked by several signs of histologic injury, including germinal aplasia and seminiferous tubule destruction, the extent of which determines the reversibility after transplantation (8,16).…”

“…Sexual function in both men and women improves after transplantation (8,10 -12), although one report suggested that one quarter of patients remained sexually dysfunctional 3 yr after transplantation (12). Female infertility results from altered hypothalamic function and is associated with high follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin levels (8). The hormone aberrations are usually reversed after transplantation, resulting in normal ovulatory cycles and regular menstruation (8,13,14).…”

“…The testis is marked by several signs of histologic injury, including germinal aplasia and seminiferous tubule destruction, the extent of which determines the reversibility after transplantation (8,16). Transplantation restores the balance in the hypothalamic-pituitary axis and consequently is associated with improvements in sperm motility but not in sperm counts or morphology (17).…”

“…Female infertility results from altered hypothalamic function and is associated with high follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin levels (8). The hormone aberrations are usually reversed after transplantation, resulting in normal ovulatory cycles and regular menstruation (8,13,14). Many women with chronic kidney disease (CKD) experience premature menopause, on an average of 4.5 yr earlier than in the general population (15); therefore, chronological age and risk for early menopause should be considered in the optimal timing of pregnancy after transplantation.…”

“…Male and female patients with end-stage kidney disease commonly experience sexual dysfunction and infertility as a result of endocrine aberrations, vasomotor dysfunction, prescribed medications, and psychological factors (8,9). Sexual function in both men and women improves after transplantation (8,10 -12), although one report suggested that one quarter of patients remained sexually dysfunctional 3 yr after transplantation (12).…”