Should egg freezing and HRT be done before dialysis in CKD?

Question

Hello doctor,

I am 33 years old and have stage 4 chronic kidney disease due to lupus nephritis. My periods stopped eight months ago (secondary amenorrhea), and I am now experiencing severe menopausal symptoms, hot flashes, night sweats, vaginal dryness, and complete loss of libido. These changes have caused emotional distress and are affecting my marriage, mainly due to painful intercourse.

Before my kidney function declined, my husband and I attempted IVF twice, but both cycles failed. Now that I may be approaching dialysis, should I consider urgent egg freezing or embryo banking? Also, would hormone replacement therapy (HRT) help relieve my symptoms, or is it not safe for advanced kidney disease? Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

Emergency egg freezing and embryo banking:

Given your diagnosis of stage 4 chronic kidney disease or CKD (severe kidney damage with greatly reduced kidney function) due to lupus nephritis (kidney inflammation caused by the autoimmune disease lupus, leading to kidney damage) and the onset of early menopause, considering emergency egg freezing or embryo banking before starting dialysis may be a reasonable option. However, this decision must be made carefully with input from your nephrologist and a fertility specialist. They can assess your overall health, kidney function, and ability to tolerate ovarian stimulation to help determine if fertility preservation is feasible and safe at this stage.

Hormone replacement therapy (HRT):

HRT can be effective in relieving severe menopausal symptoms, such as hot flashes, night sweats, vaginal dryness, and reduced libido (natural sexual desire). These symptoms can impact your quality of life and relationships. However, HRT may not be suitable for all individuals with CKD due to potential cardiovascular and metabolic risks. It is essential to consult with your nephrologist and gynecologist to evaluate whether HRT is safe for you or if non-hormonal alternatives may be more appropriate.

I recommend scheduling a consultation if you want more detailed guidance tailored to your situation. You are not alone, and there are options to support both your reproductive and emotional health.

I hope this helps.

Please revert in case of further queries.

Thank you.