title: Contraception in women after organ transplantation.
abstract: BACKGROUND
  Organ transplantation has improved the quality and length of life for many people suffering from end-stage diseases, among them women of reproductive age. Therefore, it has made pregnancy possible for those previously unable to conceive. Nevertheless, conception itself should be desired and properly timed in these specific patients to ensure the best possible perinatal outcome.
  
  
  OBJECTIVE
  The objective of the study was to assess whether female graft recipients apply proper family planning methods and use effective contraception.
  
  
  METHODS
  In a single-center, observational study, information was collected using a self-administered questionnaire distributed among 100 female graft recipients (post-transplant group [TG]) and 67 healthy female volunteers (control group [CG]). The survey covered data regarding present menstrual patterns, sexual activity, gynecological counseling, and contraceptive methods used.
  
  
  RESULTS
  Female graft recipients were more sexually active after than before transplantation (87% vs 64%, P = .0001) and equally active as controls. Sexually active post-transplantation patients used contraception less frequently than sexually active controls (51.72% vs 82.76%, P < .0001). Condoms were the most frequently used method in TG, and oral contraception in CG. Oral contraception was used more rarely by counseled graft recipients than by counseled controls (3.9% vs 60.7%, P < .0001). After counseling, intrauterine device usage increased and oral contraception usage decreased in TG. Among women with chronic diseases, intrauterine device was used more often in TG (4% vs 0%), whereas oral contraception was used more often in CG (8.3% vs 50%, P < .0001).
  
  
  CONCLUSIONS
  Despite the fact that post-transplantation women of reproductive age have many indications for highly effective contraception, only few of them actually use it. Contraceptive counseling has to be included as part of routine post-transplantation care by all health professionals involved in the management of female graft recipients of reproductive age.
authors.affiliation: First Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland. Electronic address: iwo.md@interia.pl.
authors.forename: I
authors.initials: I
authors.lastname: Szymusik
authors.affiliation: First Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Szpotanska-Sikorska
authors.affiliation: First Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland.
authors.forename: N
authors.initials: N
authors.lastname: Mazanowska
authors.affiliation: Department of Immunology, Transplant Medicine and Internal Diseases, Transplantation Institute, Medical University of Warsaw, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Ciszek
authors.affiliation: First Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Wielgos
authors.affiliation: First Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland.
authors.forename: B
authors.initials: B
authors.lastname: Pietrzak
mesh_terms: D000293:Adolescent; D000328:Adult; D003267:Contraception / Q000379:methods*; D003376:Counseling / Q000379:methods*; D005260:Female; D006801:Humans; D016377:Organ Transplantation; D011247:Pregnancy; D012725:Sexual Behavior; D055815:Young Adult