OBJECTIVES: End-stage renal failure is associated with amenorrhaea and extremely reduced fertility. After successful kidney transplantation restoration of menstrual function is observed. The aim of the study was to investigate ovarian function and menstrual cycles in kidney-transplanted women of reproductive age.
MATERIALS AND METHODS: 55 ovarian cycles in kidney transplanted women, aged 18-40 years, being one to five years after transplantation, were analyzed and compared with 50 cycles of healthy women. The duration of the cycles as well as FSH, LH, estradiol, progesterone, prolactin and testosterone serum concentrations were monitored. Simultaneously the presence of ovulation was evaluated with repeated sonographic examinations.
RESULTS: Regular menstrual cycles were observed in 72.7% of kidney transplanted women. The rates of ovulatory cycles were similar in the study group and the control: 65% and 70% respectively. Mean estradiol level in the follicular phase of the cycle was significantly higher in transplant patients (205.9, SD 160.22 vs 135.9 pg/ml, SD 68.34 in the control). Significantly lower levels of progesterone (13.2 ng/ml, SD 14.2 vs 26.7 ng/ml, SD 14.1 in the control) and testosterone were observed in kidney recipients. Other hormonal parameters did not differ significantly between the groups.
CONCLUSIONS: The rate of ovulatory cycles in regularly menstruated kidney transplanted patients is similar to that of healthy women. Similar serum FSH, LH and PRL concentrations as well as increased levels of estrogens are observed in kidney graft recipients in comparison to healthy non-recipients. Increased levels of estrogens put that group of patients at risk of gynecological pathologies.