Marriage & Pregnancy
Marriage, intimacy, contraception, and a planned pregnancy after a kidney transplant — what is safe, what to adjust, and when to start trying.
Key Points
- Wait at least one year of a stable graft before trying to conceive — creatinine steady, no recent rejection, no active infection.
- Mycophenolate (CellCept / Myfortic) is stopped at least six weeks and sirolimus (Rapamune) at least twelve weeks before you try to conceive, with a switch to Imuran (azathioprine); everolimus (Certican) is usually stopped two months before. Your transplant team makes these changes and chooses the replacement — never stop them without one.
- Stop the blood-pressure pills whose names end in -pril or -sartan before you try to conceive; switch to labetalol, methyldopa, or long-acting nifedipine.
- Start folic acid 5 mg daily three months before you try to conceive, and keep it through the first trimester.
- Breastfeeding is safe on Prograf, Neoral, Imuran, and a low daily dose of prednisolone — mycophenolate (CellCept / Myfortic) is contraindicated while you nurse, and sirolimus, everolimus, and belatacept are avoided because the human data are not sufficient.
- Pregnancy can lower measured whole-blood levels of tacrolimus or cyclosporine; any dose change is decided by your transplant team after blood-level monitoring.
- Take a low-dose baby-aspirin (75 to 150 mg) every day from week twelve of pregnancy until close to delivery to lower the risk of pre-eclampsia.
- Long-acting reversible contraceptives — the hormonal coil, the copper coil, and the implant under the skin — are the first-line choice; condoms alone are less reliable.
Clinical review
Reviewed by Dr Osama Ashry Gheith, Consultant Transplant Nephrologist. Kuwait Center for Nephrology and Kidney Transplantation (KCNKT). Mansoura Urology and Nephrology Center, Egypt. Reviewed 1 August 2026.
About the Transplant Patient Portal
This chapter is part of ASNRT's bilingual (Arabic / English) transplant patient-education portal — 14 clinical chapters covering kidney transplantation from preparation through long-term follow-up, plus decision-aid tools for Ramadan fasting, drug-food interactions, and red-flag symptom triage.
النسخة العربية من هذه الصفحة · All transplant chapters · ASNRT home