Contraception for women with a history of solid organ transplantation

For women with uncomplicated solid organ transplantation, the US Medical Eligibility Criteria for Contraceptive Use consider all methods of contraception category 2 (benefits generally outweigh risks). Pregnancy is not recommended until graft function is stable, and thereafter should be carefully timed in conjunction with a transplant team. For this reason, it is recommended that patients with a history of transplantation use highly effective methods of contraception when not actively trying to conceive. The only types of contraception that have been systematically studied in women after transplantation are combined hormonal contraception and the intrauterine device (IUD). IUDs were historically thought to be contraindicated in a post-transplant population, but modern literature is overwhelmingly reassuring. These studies, though small series, are largely reassuring. Long-acting reversible contraception (LARC) methods are underutilized in this population.