CKD and Fertility: Understanding the Connection

If you’re living with chronic kidney disease (CKD), you may wonder how it could affect your ability to start or grow a family. Fertility, your natural ability to have children, is shaped by many factors, including age, hormones, and overall health. For people with CKD, these factors become more complex because the kidneys play a role in hormone regulation and reproductive health. While some people continue to conceive naturally, others may face challenges. The good news: treatments like transplantation and support from specialists can help restore fertility and improve outcomes.*

How CKD Affects Women’s Fertility

Your kidneys aren’t just filters; they also influence hormone cycles that regulate ovulation and menstruation. As kidney function declines, especially when your estimated glomerular filtration rate (eGFR) drops below 15 mL/min, fertility often decreases. You may notice irregular periods, longer cycles, or, in some cases, your periods may stop completely. This is a sign that ovulation, the release of eggs necessary for pregnancy, has stopped.

Advanced CKD can make becoming pregnant more difficult, but the degree of impact varies. Some women with earlier stages of CKD can still conceive, though it may take longer. Talking openly with your nephrologist about your pregnancy goals is an important step to planning safely.

How CKD Affects Men’s Fertility

If you are a man living with CKD, you may also face fertility challenges. Kidney disease can cause hormonal changes that affect arousal, sperm production, and erectile function. Beyond CKD itself, related conditions such as high blood pressure and diabetes can damage blood vessels and lead to erectile dysfunction.

Certain medications prescribed for CKD may lower sperm count or affect how sperm move and function. Dialysis, while life-sustaining, can also reduce sperm quality. These changes don’t mean fertility is impossible, but they do highlight the importance of specialized care and conversations with your healthcare team.

Fertility After Kidney Transplant

One of the most hopeful outcomes for people with CKD is the improvement in fertility after a kidney transplant. A functioning kidney helps restore hormone cycles, and many women resume regular menstrual periods within six weeks. Fertility rates for both women and men often return to levels similar to the general population.

That said, planning a pregnancy after a transplant requires careful timing and medical guidance. Some anti-rejection medications can harm a developing baby, so you’ll need to work closely with your transplant team and possibly a reproductive endocrinologist. With the right planning, many people successfully build families post-transplant.

Taking Action if You’re Struggling with Fertility

Facing infertility can feel overwhelming, but you don’t have to go through it alone. Start by sharing your pregnancy goals with your nephrologist. If you feel unheard or unsupported, it’s okay to request a referral to a fertility specialist or even seek a new nephrologist. 

Fertility specialists, known as reproductive endocrinologists, can evaluate your situation more closely and guide you through available options.

Just as importantly, remember that fertility struggles are not only medical but also emotional. Reaching out for support, whether through counseling, peer groups, or patient communities, can make a big difference as you navigate next steps.

*American Kidney Fund. (September 24, 2024) “Chronic Kidney Disease (CKD) and Fertility”. https://www.kidneyfund.org/living-kidney-disease/chronic-kidney-disease-ckd-and-fertility

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