University of Southern California, Irvine, 333 City Blvd West, #1400, Orange, CA 92868.
Contraception. 2019 Sep;100(3):250-252. doi: 10.1016/j.contraception.2019.05.012. Epub 2019 May 31.
With an ever-increasing number of reproductive-aged women undergoing solid organ transplant and fertility improving after transplant, knowledge of the safety and efficacy of various contraceptive methods is essential to guide patient selection. We present the case of a 22-year-old patient desiring an intrauterine device (IUD) for contraception with a history of liver transplant as a child. The Centers for Disease Control and Prevention (CDC) and American Society for Transplantation (AST) offer conflicting recommendations on the use of IUDs in transplant patients. We review the literature for recommendations on IUD use in this population. While the literature is limited, levonorgestrel (LNG) and copper (Cu) IUDs appear to be safe and effective in solid organ transplant patients, with no evidence of unintended pregnancies or complications compared to those without organ transplant. Ultimately, patient preference should be the primary consideration in contraceptive choice, including between LNG or Cu-IUD.
随着越来越多的育龄妇女接受实体器官移植，并且移植后生育能力得到提高，了解各种避孕方法的安全性和有效性对于指导患者选择至关重要。我们介绍了一位 22 岁的患者，她希望通过宫内节育器（IUD）避孕，她小时候曾接受过肝脏移植。疾病控制与预防中心（CDC）和美国移植协会（AST）对移植患者使用 IUD 提出了相互矛盾的建议。我们回顾了有关该人群中 IUD 使用的文献。虽然文献有限，但左炔诺孕酮（LNG）和铜（Cu）IUD 似乎在实体器官移植患者中是安全有效的，与没有器官移植的患者相比，没有意外怀孕或并发症的证据。最终，患者的偏好应成为避孕选择的主要考虑因素，包括 LNG 或 Cu-IUD 之间的选择。
