TY - JOUR
T1 - Female infertility in Chronic Kidney Disease
AU - Bhaduri, Mahua
AU - Bramham, Kate
AU - Sarris, Ippokratis
PY - 2023/10/23
Y1 - 2023/10/23
N2 - Abstract: This review summarises the current literature for infertility in women with Chronic Kidney Disease (CKD), describing the epidemiology, pathophysiology, investigations and man-agement options. The pathophysiology is multifactorial, with proposed mechanisms including disruption of the hypothalamus-pituitary-ovarian axis, chronic inflammation, oxidative stress, psychological factors and gonadotoxic effects of medications such as cyclophosphamide. Diag-nostic investigations in CKD patients seeking to conceive should be considered earlier than in the healthy population. Investigations should include hormonal profiling, including markers such as Anti-Mullerian Hormone and imaging such as ultrasound to evaluation ovarian reserve and identify gynaecology pathology. Treatment options for infertility in CKD patients include GnRH agonists to preserve ovarian function during cyclophosphamide treatment, assisted reproductive technologies including in-vitro fertilisation and ovulation induction. However, these treatments must be tailored to the individual’s health status, comorbidities, fertility requirements and CKD stage. In conclusion, fertility is an important consideration for women with CKD, necessitating early investigation and tailored management. Early discussions regarding fertility is important to understand patients’ family planning and allows for prompt referral to fertility services. While challenges exist, ongoing research aims to clarify the underlying mechanism and optimise treat-ment strategies, which are crucial to improving quality of life and overall health outcomes.
AB - Abstract: This review summarises the current literature for infertility in women with Chronic Kidney Disease (CKD), describing the epidemiology, pathophysiology, investigations and man-agement options. The pathophysiology is multifactorial, with proposed mechanisms including disruption of the hypothalamus-pituitary-ovarian axis, chronic inflammation, oxidative stress, psychological factors and gonadotoxic effects of medications such as cyclophosphamide. Diag-nostic investigations in CKD patients seeking to conceive should be considered earlier than in the healthy population. Investigations should include hormonal profiling, including markers such as Anti-Mullerian Hormone and imaging such as ultrasound to evaluation ovarian reserve and identify gynaecology pathology. Treatment options for infertility in CKD patients include GnRH agonists to preserve ovarian function during cyclophosphamide treatment, assisted reproductive technologies including in-vitro fertilisation and ovulation induction. However, these treatments must be tailored to the individual’s health status, comorbidities, fertility requirements and CKD stage. In conclusion, fertility is an important consideration for women with CKD, necessitating early investigation and tailored management. Early discussions regarding fertility is important to understand patients’ family planning and allows for prompt referral to fertility services. While challenges exist, ongoing research aims to clarify the underlying mechanism and optimise treat-ment strategies, which are crucial to improving quality of life and overall health outcomes.
M3 - Article
SN - 2075-4418
JO - Diagnostics (Basel, Switzerland)
JF - Diagnostics (Basel, Switzerland)
ER -
