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The Pearl Index Failure Rates of contraceptives Type of contraception Failure rate Lactation for 12 months 25 

The Pearl Index Failure Rates of contraceptives Type of contraception Failure rate Lactation for 12 months 25 

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Fertility is improved within months and conception is achieved within one to six years after kidney transplantation. Pregnancy is safe and has little effect on long-term graft survival, but has increased maternal and fetal risks. Pregnancy is contraindicated in the first two years post-kidney transplantation due to increased risk of acute rejection...

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... addi- tion, contraceptive failure was found to be associated with being single, a student, and having given birth twice or more previously. 47 McLure 48 described the Pearl Index failure rates of contraceptives, where lactation for 12 months, coitus interruptus and symptothermal method carried the highest failure rates while tubal ligation, vasectomy, combined pill and condom had the least failure rates (Table 1). ...

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... It has various side effects such as weight gain, amenorrhoea or irregular bleeding, drug interaction with calcineurin inhibitors and glucocorticoids and alteration in lipid metabolism. [23] Progestogen-only injectable includes DMPA. It is synthetic progesterone to be given intramuscularly at every 12 weeks interval. ...
Article
Solid-organ transplant increases the physical and mental well-being of women suffering from chronic kidney diseases. It also improves the menstrual and reproductive function of the transplant recipient, putting a woman at risk of unplanned pregnancy. Various contraceptive options are available to such women. According to the World Health Organization Medical Eligibility Criteria, almost all contraceptive methods belong to Category 2 for uncomplicated post-transplant recipients. For complicated renal-transplant patients, intra-uterine devices are Category 3/2, and combined hormonal contraceptives are Category 4. It is of paramount importance to discuss the pros and cons of each method, and this counselling should be included routinely before undergoing transplant surgery.
... Given the pregnancy-associated risks described and the fact that fertility can be efficiently reverted within 1 to 6 months after kidney transplant; it is essential that methods of contraception are discussed before and initiated soon after transplant surgery to prevent premature, unplanned, and unadvised pregnancies. 26 These measures would reduce the possible complications and adverse events that might occur during pregnancy after kidney transplant. Other concerns include optimization of immuno suppressive agents ( Table 2) 27 and antihypertensive medications, since not all medications are safe during pregnancy. ...
... and the difficulty in achieving compliance. 26,32 Barrier success rate can reach 97% if used correctly and consistently. They have the advantage of being a convenient and easy to use method of contraception while also avoiding potential drug interactions, especially with immunosuppressive medications. ...
... All of these barrier methods can be used posttransplant but are best when combined with another method of birth control to reduce their potential failure rate. 26 Education of couples regarding this method of contraception encourages awareness and compliance and may reduce the failure rate of this method. 66 ...
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There is a misconception among transplant clinicians that contraception after a successful renal transplant is challenging. This is partly due to the complex nature of transplant patients, where immunosuppression and graft dysfunction create major concerns. In addition, good evidence regarding contraception and transplant is scarce, with most of the evidence extrapolated from observational and case-controlled studies, thus adding to the dilemma of treating these patients. In this review, we closely analyzed the different methods of contraception and critically evaluated the efficacy of the different options for contraception after kidney transplant. We conclude that contraception after renal transplant is successful with acceptable risk. A multidisciplinary team approach involving obstetricians and transplant clinicians to decide the appropriate timing for conception is recommended. Early counseling on contraception is important to reduce the risk of unplanned pregnancies, improve pregnancy outcomes, and reduce maternal complications in patients after kidney transplant. To ascertain appropriate advice on the method of contraception, individualizing the method of contraception according to a patient's individual risks and expectations is essential.
... French VA et al. demonstrated that the proportion of female organ transplant recipients using any contraception was 48% during the posttransplantation period [18]. Other studies have shown that the proportion of hormonal contraception is even lower than estimateda mere 2% [2,21]. In our study, when considering only currently sexually active women, the proportion of any contraception usage ranged from 83 to 90% in the studied groups. ...
... However, the available literature indicates that the rates of long-term effective contraception in female organ transplant recipients significantly vary. The use of female sterilization ranges from 14 to 31% and of IUDs from 0 to 14% [2,10,18,21]. Thus, the low usage rates of long-acting contraceptive methods observed within our study population are predominantly attributed to the generally low rates of female sterilization. ...
... Gebelik planlaması düşük rejeksiyon riski, immünsüpresif ajanların daha düşük dozlarda kullanılması ve stabilize renal fonksiyonun sağlanması nedeniyle transplantasyondan yaklaşık 2 sene sonra yapılmalıdır. [3] Doğurgan çağdaki fonksiyon gören böbreğe sahip ortalama her 50 kadından birinin gebe kalabildiği düşünülmektedir. Bununla birlikte bu hastaların çoğu kez son dönem böbrek yetersizliği ile birlikte gözlenebilen infertilitenin trans-plantasyon ile azalabileceği hakkında bilgileri mevcut değildir. ...
... Gebelik planlaması düşük rejeksiyon riski, immünsüpresif ajanların daha düşük dozlarda kullanılması ve stabilize renal fonksiyonun sağlanması nedeniyle transplantasyondan yaklaşık 2 sene sonra yapılmalıdır. [3] Doğurgan çağdaki fonksiyon gören böbreğe sahip ortalama her 50 kadından birinin gebe kalabildiği düşünülmektedir. Bununla birlikte bu hastaların çoğu kez son dönem böbrek yetersizliği ile birlikte gözlenebilen infertilitenin trans-plantasyon ile azalabileceği hakkında bilgileri mevcut değildir. ...
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Even though fertility is reduced, conception and delivery are possible in all stages of CKD. While successful planned pregnancies are increasing, an unwanted pregnancy may have long-lasting deleterious effects, hence the importance of birth control, an issue often disregarded in clinical practice. The evidence summarized in this position statement is mainly derived from the overall population, or other patient categories, in the lack of guidelines specifically addressed to CKD. Oestroprogestagents can be used in early, non-proteinuric CKD, excluding SLE and immunologic disorders, at high risk of thromboembolism and hypertension. Conversely, progestin only is generally safe and its main side effect is intramestrual spotting. Non-medicated intrauterine devices are a good alternative; their use needs to be carefully evaluated in patients at a high risk of pelvic infection, even though the degree of risk remains controversial. Barrier methods, relatively efficacious when correctly used, have few risks, and condoms are the only contraceptives that protect against sexually transmitted diseases. Surgical sterilization is rarely used also because of the risks surgery involves; it is not definitely contraindicated, and may be considered in selected cases. Emergency contraception with high-dose progestins or intrauterine devices is not contraindicated but should be avoided whenever possible, even if far preferable to abortion. Surgical abortion is invasive, but experience with medical abortion in CKD is still limited, especially in the late stages of the disease. In summary, personalized contraception is feasible, safe and should be offered to all CKD women of childbearing age who do not want to get pregnant.
Article
Women undergoing solid organ transplantation are advised to avoid pregnancy for up to 24 months following transplant surgery. We conducted a systematic review of the literature, from database (PubMed) inception through February 2009, to evaluate evidence on the safety and effectiveness of contraceptive use among women having undergone solid organ transplantation. From 643 articles, eight articles from seven studies satisfied review inclusion criteria; six articles pertained to kidney transplant patients, and two reported on liver transplant patients. Two reports of one prospective cohort of 36 kidney transplant recipients taking combined oral contraceptives (COCs) or using the transdermal contraceptive patch reported no significant changes in biochemical measures after 18 months of use for either group, although 13 women modified antihypertensive medication, and two women discontinued the study because of serious medical complications. Four case reports of five kidney recipients using intrauterine devices reported inconsistent findings, including both beneficial health effects and contraceptive failures. One retrospective, noncomparative study of 15 liver transplant recipients using COCs or the transdermal contraceptive patch found no significant changes in any biochemical measures obtained, no discontinuations or severe complications and no pregnancies after a 12-month follow up. One case report of a liver transplant recipient on cyclosporine and prednisone documented the development of cholestasis associated with high-dose (50 mcg ethinyl estradiol) COC use as treatment for heavy uterine bleeding. Very limited evidence on COC and transdermal contraceptive patch use among kidney and liver transplant recipients indicated no pregnancies and no overall changes in biochemical measures. Excluding case reports, evidence on other contraceptive methods or contraception among other types of solid organ transplants was not identified.