*Purpose: Infertility is common among female kidney transplant recipients (KTRs). In vitro fertilization (IVF) is a potential option. The purpose of this study was to survey the safety and success rate of pregnancy via IVF among female KTRs.

*Methods: Data were collected by the Transplant Pregnancy Registry International through questionnaires, telephone interviews, transplant staff, and hospital records.

*Results: Of 1,218 female KTRs reporting to the TPRI, 33 recipients reported using IVF for conception: 42 pregnancies with 46 outcomes, includes 4 sets of twins. (Table 1) Issues reported during pregnancy included: chronic hypertension 45%, preeclampsia 29%, gestational diabetes 14%, and placental anomalies 17%. Only 1 recipient experienced rejection during pregnancy. Pregnancy outcomes were: 36 live births (86%), 4 spontaneous abortions, 1 ectopic, and 1 stillbirth. Data as median (IQR): maternal age at conception 36 years (33-39), gestational age 36.0 weeks (32-38), and birth weight 2579 g (1576-3005). Delivery by Cesarean section 57%. At last follow-up at an average age of 7.6 years, 39 children were reported healthy and developing well. Congenital defects were seen in 4 newborns: 1 cleft lip and palate, 1 duodenal atresia, and 2 were lip and tongue tied. Maternal follow-up was a median of 5 years with 81% reporting adequate graft function. Three recipients died from 11 months to 22 years postpartum, Causes of death: 2 myocardial infarction and 1 cancer. Six recipients (14%) experienced graft loss within 2 years of their last pregnancy. There was no difference in long term graft survival between KTRs who conceived with vs without IVF. (Figure 1).

*Conclusions: Successful pregnancies via IVF were reported in female KTRs with livebirths in 86% of pregnancies. Long-term graft survival was not affected in female KTRs conceiving via IVF. Kidney transplant recipients who require fertility assistance should not be discouraged from utilizing IVF.

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