vtioВестник трансплантологии и искусственных органовRussian Journal of Transplantology and Artificial Organs1995-1191Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation10.15825/1995-1191-2022-4-15-23vtio-1554Research ArticleКлиническая трансплантологияClinical TransplantologyБеременность после экстракорпорального оплодотворения у пациентки с трансплантированной почкой: клиническое наблюдение и обзор литературыIVF pregnancy after kidney transplantation: clinical case and literature reviewПрокопенкоЕ. И.ProkopenkoE. I.

Прокопенко Елена Ивановна

129110, Москва, ул. Щепкина, д. 61/2

Тел. (495) 681-55-85

Elena Prokopenko

61/2, Shchepkina str., Moscow, 129110, Russian Federation

Phone: (495) 681-55-85

renalnephron@gmail.comГурьеваВ. М.GuryevaV. M.

 Москва

Moscow

ПетрухинВ. А.PetrukhinV. A.

 Москва

Moscow

КраснопольскаяК. В.Krasnopol’skayaK. V.

 Москва

Moscow

БурумкуловаФ. Ф.BurumkulovaF. F.

 Москва

Moscow

ГубинаД. В.GubinaD. V.

 Москва

Moscow

ГБУЗ МО «Московский областной научно-исследовательский клинический институт имени М.Ф. Владимирского»; ГБУЗ МО «Московский областной научно-исследовательский институт акушерства и гинекологии»РоссияVladimirsky Moscow Regional Research Clinical Institute; Moscow Regional Research Institute of Obstetrics and GynecologyRussian FederationГБУЗ МО «Московский областной научно-исследовательский институт акушерства и гинекологии»РоссияMoscow Regional Research Institute of Obstetrics and GynecologyRussian FederationГБУЗ МО «Московский областной научно-исследовательский клинический институт имени М.Ф. Владимирского»РоссияVladimirsky Moscow Regional Research Clinical InstituteRussian Federation2022290720222441523Copyright © Прокопенко Е.И., Гурьева В.М., Петрухин В.А., Краснопольская К.В., Бурумкулова Ф.Ф., Губина Д.В., 20222022Прокопенко Е.И., Гурьева В.М., Петрухин В.А., Краснопольская К.В., Бурумкулова Ф.Ф., Губина Д.В.Prokopenko E.I., Guryeva V.M., Petrukhin V.A., Krasnopol’skaya K.V., Burumkulova F.F., Gubina D.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.transpl.ru/vtio/article/view/1554

Трансплантация почки (ТП), являющаяся оптимальным методом лечения ХБП 5-й стадии, восстанавливает нарушенную фертильность у большинства женщин репродуктивного возраста. Однако у части пациенток после успешной ТП выявляется бесплодие. Мы приводим собственный опыт преодоления вторичного трубного бесплодия с помощью экстракорпорального оплодотворения (ЭКО) у 36-летней пациентки с трансплантированной почкой, имевшей две потери беременности в анамнезе из-за тяжелой преэклампсии (ПЭ). После второй попытки ЭКО-крио на фоне заместительной гормональной терапии, переноса одного эмбриона в полость матки наступила беременность. В первом триместре диагностирован гестационный сахарный диабет (ГСД), назначена диета. В течение беременности проводилась иммуносупрессия такролимусом, азатиоприном и метилпреднизолоном, профилактика ПЭ низкомолекулярным гепарином и антиагрегантами. В 37–38 недель выполнено плановое кесарево сечение, родился здоровый мальчик массой 2760 г (25-й перцентиль), ростом 48 см (36-й перцентиль). Пребывания в отделении реанимации новорожденных не потребовалось. Ребенок растет и развивается нормально, у матери функция ренального трансплантата удовлетворительная. Таким образом, ЭКО может с успехом использоваться у пациенток после ТП с бесплодием при условии тщательного контроля программы ЭКО и мультидисциплинарного ведения беременности.

Kidney transplantation (KT), the optimal treatment for stage 5 chronic kidney disease (CKD), restores impaired fertility in most women of reproductive age. However, infertility occurs in some patients after successful KT. We present our own experience of overcoming secondary tubal infertility by in vitro fertilization (IVF). The patient was a 36-year-old with a transplanted kidney, who had lost two pregnancies in the past due to severe preeclampsia (PE). After the second attempt on cryo-thawed embryo transfer against the background of hormone replacement therapy, one embryo was transferred into the uterus, resulting in pregnancy. Gestational diabetes mellitus (GDM) was diagnosed in the first trimester, and a diet was prescribed. Immunosuppression with tacrolimus, azathioprine and methylprednisolone, prophylaxis of PE with low molecular weight heparin and antiplatelet drugs were administered during pregnancy. Elective cesarean section was performed at 37–38 weeks and a healthy boy was born, weighing 2760 g (25th percentile), 48 cm tall (36th percentile). A stay in the neonatal intensive care unit was not required. The baby is growing and developing normally, the mother’s renal graft function is satisfactory. So, IVF can be successfully used in post-KT patients with infertility issues, provided that the IVF program is carefully controlled, and the pregnancy is managed in a multidisciplinary manner.

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The authors declare that there are no conflicts of interest present.