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World J Transplant. Sep 18, 2025; 15(3): 103958
Published online Sep 18, 2025. doi: 10.5500/wjt.v15.i3.103958
Advances in fertility preservation and pregnancy care for transplant patients
Velik Lazarov, Emilia Naseva, Dimitrina Georgieva Miteva, Latchezar P Tomov, Russka Shumnalieva, Milena Peruhova, Tsvetelina Velikova
Velik Lazarov, Department of Obstetrics and Gynaecology, Second Specialised Hospital for Obstetrics and Gynaecology "Sheynovo", Sofia 1504, Bulgaria
Emilia Naseva, Faculty of Public Health, Medical University of Sofia, Sofia 1431, Bulgaria
Emilia Naseva, Dimitrina Georgieva Miteva, Latchezar P Tomov, Russka Shumnalieva, Tsvetelina Velikova, Medical Faculty, Sofia University St. Kliment Ohridski, Sofia 1407, Bulgaria
Dimitrina Georgieva Miteva, Department of Genetics, Faculty of Biology, Sofia University "St. Kliment Ohridski, Sofia 1164, Bulgaria
Latchezar P Tomov, Department of Informatics, New Bulgarian University, Sofia 1618, Bulgaria
Russka Shumnalieva, Department of Rheumatology, Clinic of Rheumatology, University Hospital "St. Anna", Medical University-Sofia, Sofia 1907, Bulgaria
Milena Peruhova, Department of Gastroenterology, Heart and Brain Hospital, Burgas 8000, Bulgaria
Author contributions: Lazarov V and Velikova T were involved in conceptualizing the idea and writing the draft; Naseva E, Miteva DG, Tomov LP, Shumnalieva R and Peruhova M wrote additional sections in the paper; Velikova T and Lazarov V craftedthe table; Velikova T was responsible for criticallyrevising the manuscript for relevant intellectual content. All of the authorsapproved the final version of the paper before submission.
Supported by European Union-Next Generation EU, through the National Recovery and Resilience Plan of the Republic of Bulgaria, No. BG-RRP-2.004-0008.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Velik Lazarov, MD, PhD, Assistant Professor, Department of Obstetrics and Gynaecology, Second Specialised Hospital for Obstetrics and Gynaecology "Sheynovo", Sheinovo 19, Sofia 1504, Bulgaria. dr.v.lazarov@gmail.com
Received: December 6, 2024
Revised: January 23, 2025
Accepted: February 18, 2025
Published online: September 18, 2025
Processing time: 134 Days and 8.3 Hours
Abstract

Fertility preservation and pregnancymanagement are critical considerations for patients undergoing organtransplantation. Innovations in assisted reproductive technologies, hormonalmodulation, and personalized medicine have expanded options for these patients, who face unique challenges due to immunosuppressive therapy and organ functionconcerns. This mini-review explores advancements in cryopreservationtechniques, pre-conception counseling, and multidisciplinary strategies forsafe pregnancies post-transplantation. Emphasis is placed on balancing maternalhealth, graft function, and fetal outcomes. The integration of reproductive andtransplant medicine is paving the way for improved quality of life andreproductive autonomy for this patient population.

Keywords: Fertility preservation; Pregnancy management; Organ transplantation; Cryopreservation; Assisted reproductive technology; Immunosuppressive therapy; Reproductive health

Core Tip: Fertility preservation and pregnancy management in transplant patients require an inter disciplinary approach integrating advancements in reproductive medicine and transplant care. Innovations such as cryopreservation, personalized immunosuppressive protocols, and pre-conception counseling have significantly improved outcomes. Addressing unique challenges like graft function and fetal health, these strategies offer transplant recipients the opportunity to achieve parenthood safely. Continued research and collaboration are essential to refine care models and enhance reproductive autonomy in this population.