Advances in fertility preservation and pregnancy care for transplant patients

Table 1 Innovations in fertility preservation and pregnancy management for transplant patients, along with their successes and limitations/challenges

Innovation	Successes	Limitations/challenges	Ref.
Oocyte cryopreservation	Successful long-term storage of oocytes before transplant procedures	Potential risk of ovarian failure due to immunosuppressive therapy	[17]
	Offers female transplant patients the possibility of future fertility options	Limited knowledge of the effects of cryopreservation on oocyte quality post-transplant
Embryo cryopreservation	High success rates of pregnancy post-transplant when embryos are used after fertilization	Ethical concerns and challenges with donor sperm/eggs
	Suitable for patients undergoing fertility treatment before transplantation	Requires hormonal stimulation, which may not be possible for all transplant patients due to their medical conditions
Testicular tissue cryopreservation	Success in preserving fertility in male transplant patients	Limited access and expertise in cryopreservation of testicular tissue
	Potential to preserve the ability for future sperm retrieval even after the transplant	Uncertainty of long-term success in fertility restoration
IVF	Allows transplant patients to use their gametes or preserved embryos to conceive	IVF may not be feasible for all patients due to immunosuppressive therapy or health complications
Hormonal manipulation during pregnancy	Modifies immunosuppressive therapy to reduce risks during pregnancy, leading to successful pregnancies	Risk of graft rejection or complications in maintaining immune balance
	Tailored immunosuppression protocols can enhance pregnancy outcomes for transplant patients	Hormonal therapies can have side effects that complicate pregnancy
Genetic counseling	Helps patients understand the risks of inherited diseases or the effects of transplantation on offspring	Limited access to specialized genetic counseling in some regions
	Provides a clear understanding of pregnancy and fertility options for transplant patients	Emotional and psychological challenges for patients in dealing with possible outcomes
Pre-implantation genetic testing	Identifies genetic disorders in embryos, reducing the risk of inherited conditions in offspring	High cost and limited availability of testing
	Helps to choose the healthiest embryos, which is crucial in transplant patients with compromised health	Ethical concerns surrounding genetic screening and selection
Pregnancy monitoring post-transplant	Advanced monitoring technologies help track graft function and fetal development simultaneously	The increased complexity of monitoring, especially in immunosuppressed patients, may increase medical burden
	Early intervention and personalized care plans can improve pregnancy outcomes for transplant patients	Risk of complications, including organ rejection and infection, remains a challenge

IVF: In vitro fertilization.