title: Successful Pregnancy Outcome after In Vitro Fertilization in a Kidney Graft Recipient: A Case Report and Literature Review.
abstract: BACKGROUND
  Successful spontaneous pregnancy in a kidney graft recipient is regarded as a sign of full recovery. The crucial factors determining positive outcome are optimizing time of conception and multidisciplinary team care. However, there are only a few reports dealing with in vitro fertilization (IVF) outcomes in organ recipients.
  
  
  METHODS
  A 34-year-old living donor kidney recipient with primary infertility due to bilateral tubal obstruction was referred to our clinic. Transfer of 2 embryos was conducted after a long stimulation protocol with GnRH and rFSH, and a viable singleton pregnancy was confirmed by subsequent ultrasound examination. Pregnancy complications were: chronic hypertension, fetal intrauterine growth restriction, and severe anemia requiring blood transfusions and erythropoietin treatment. In the 34th week of gestation the patient presented with worsening of blood pressure control. A male newborn, 1810 grams weight and 10 points Apgar score was delivered by cesarean section. Although our patient was qualified for the IVF program with signs of suboptimal graft function, it was stable during the ovarian stimulation protocol. Fortunately, in the second half of the pregnancy only mild creatinine rise and proteinuria <1 g/day were observed.
  
  
  CONCLUSIONS
  IVF may be a good treatment option in female kidney graft recipients. It does not necessarily lead to graft function deterioration and it provides multidisciplinary specialized care, allowing for delivery of a healthy newborn.
authors.affiliation: 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Bronisława
authors.initials: B
authors.lastname: Pietrzak
authors.affiliation: 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Natalia
authors.initials: N
authors.lastname: Mazanowska
authors.affiliation: 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Bożena
authors.initials: B
authors.lastname: Kociszewska-Najman
authors.affiliation: 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Szymusik
authors.affiliation: 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Grzechocińska
authors.affiliation: Department of Transplantation Medicine and Nephrology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Pazik
authors.affiliation: 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Zoulikha
authors.initials: Z
authors.lastname: Jabiry-Zieniewicz
authors.affiliation: Clinical Department of Internal Medicine, Nephrology and Transplantology, Central Clinical Hospital of the Ministry of Interior, Warsaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Popow
authors.affiliation: First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warszawa, Poland.
authors.forename: Mirosław
authors.initials: M
authors.lastname: Wielgos
mesh_terms: D000328:Adult; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005317:Fetal Growth Retardation / Q000175:diagnosis; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis; D007247:Infertility, Female / Q000628:therapy*; D016030:Kidney Transplantation; D011247:Pregnancy; D011256:Pregnancy Outcome; D066027:Transplant Recipients