Women who have undergone solid-organ transplantation have unique reproductive health needs, including avoiding pregnancy, especially short term, after transplant. This study aims to compare contraceptive use among reproductive-age women after heart or lung transplantation and after kidney or liver transplantation to identify opportunities to improve patient care.METHODS:
This was a cross-sectional survey at two academic health systems of reproductive-age women between 1 and 48 months post solid organ transplant. Participants completed a questionnaire regarding reproductive history and contraceptive counseling and use before and after transplant surgery.RESULTS:
Twenty-three women completed the survey. Six were heart, three were lung, and 18 were kidney or kidney/liver transplant recipients. Pregnancy counseling was usually provided before transplantation (35%) or after transplantation in the hospital or clinic (39%), with the remaining receiving no counseling on when it would be safe to consider pregnancy. While most were using a contraceptive method before and after transplant, 56% were using condoms only and 13% were using no method at all. Condoms followed by intrauterine devices (IUDs) and injectable contraceptives were the most commonly discussed/offered methods. While condom use still accounted for 55% of the heart and lung transplant recipients, all were using some method with implant/injectable/ocp accounting for the rest. The kidney group, on the other hand, had two women using IUD but the others using condoms (57%), fertility awareness, or no method (21%).CONCLUSION:
Despite increased morbidity of unintended pregnancy, heart and lung transplant patients' contraceptive counseling and utilization is similar to kidney and liver transplant patients.