Complement 3 glomerulopathy (C3G) and immune complex membranoproliferative glomerulonephritis (IC-MPGN) are rare kidney diseases that affect the kidneys’ filtering system. If you have C3G or IC-MPGN, you may have questions about pregnancy or having a baby.

Kidney disease can affect fertility in several ways. These include kidney function, hormone changes, medications, dialysis, or a past kidney transplant. Still, many people with chronic (long-term) kidney disease can have children with the right care and support.

Talking with your nephrologist early can help you understand your options before you start trying to conceive.

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Kidney Disease and Fertility

Having chronic kidney disease, such as C3G or IC-MPGN, may affect fertility in different ways depending on your body and health history. For example, it may affect ovulation, hormone levels, erections, sperm quality, or the timing of when it’s safest to try to conceive.

Talk to your doctor if you hope to have children in the future. A nephrologist (kidney doctor) can help you figure out what to expect so you can plan ahead. They can also share resources to help you avoid problems when possible.

Questions To Ask Your Doctor

Before you meet with your nephrology care team, prepare a list of questions. That way, you won’t miss any important answers while you’re at the doctor’s office.

It’s a good idea to tailor your list of questions to your goals and needs. The following options can help get you started.

Can C3G or IC-MPGN Affect My Ability To Get Pregnant?

Research shows that people with CKD have more fertility issues than people without CKD. This may be due to factors such as:

• Reduction in sperm quality
• Increased inflammation in the body
• Sexual dysfunction
• Hormone changes
• Lower reserves of eggs in the ovaries
• Disrupted ovulation cycles

Some people with C3G or IC-MPGN may have a harder time getting pregnant, especially if kidney disease is more advanced. But having chronic kidney disease doesn’t always mean you can’t get pregnant naturally. Many people with CKD are still able to have children with the right care and support.

Your doctor can explain the possible risks and ways to lower them. They’ll also share when the safest time is for you to try to conceive.

When Is the Best Time To Start Trying To Conceive?

Your doctor may advise you to get your C3G or IC-MPGN under control before trying to conceive. They can walk you through the best timeline based on your diagnosis and symptoms. If your kidney function isn’t stable, they can help you work toward improving it before you try to conceive.

Fertility may decrease as kidney function gets worse. Some people with advanced CKD may ovulate less often, which can make it harder to get pregnant naturally. However, pregnancy can still happen at different stages of CKD.

CKD complications like high blood pressure and diabetes may affect the ability to get or keep an erection. Dialysis and some medications may also cause erectile dysfunction. Talk with your doctor about your kidney function, your pregnancy risks, and the safest time to try to conceive.

Which Specialists Should I Meet With?

Ask your kidney specialist which other healthcare professionals you may need to see before trying to have a baby. These providers may include:

• OB-GYN — An expert in gynecology and obstetrics
• Maternal-fetal medicine specialists — OB-GYNs who have special training in high-risk pregnancies
• Reproductive endocrinologists — Specialists in fertility medicine
• Nephrologists — Doctors who specialize in C3G, IC-MPGN, or other kidney issues and can share information about CKD with the rest of your care team
• Counselors — Mental health professionals who can talk with you about what to consider before pregnancy
• Urologists — Specialists who can assess sperm count and sperm quality, as well as address erectile dysfunction

If you meet with a specialist who doesn’t support your family planning goals, consider getting a second opinion. Your doctors should be clear about risks and possible complications. But they should also listen to you and help you find solutions.

Could My Medications Affect Fertility or Conception?

Some medications used to treat C3G, IC-MPGN, or CKD complications may affect fertility or conception. Others may need to be changed before you start trying to conceive because they may not be safe during pregnancy.

Some blood pressure medicines aren’t usually used during pregnancy because they can harm the baby. These include angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers.

Newer treatments that affect the complement system, a part of the immune system, may also need to be reviewed closely before pregnancy. Ask your nephrologist whether any C3G or IC-MPGN medicines should be continued, changed, or stopped.

Don’t stop or change any medications on your own. Your nephrologist can help you understand whether a medication change is needed and how long you may need to wait before trying to conceive.

Can I Get Pregnant After a Kidney Transplant?

After a kidney transplant for C3G or IC-MPGN, hormone levels may become more stable, which can improve fertility. Many people can have a successful pregnancy afterward. However, pregnancy is safest when the transplanted kidney is working well, blood pressure is controlled, protein levels in the urine are low, and there has not been a recent rejection episode.

It’s also important to ask your doctor whether your posttransplant medications could affect the baby. They can help you determine whether any drug changes are needed before you start a family.

Which Tests Do I Need Before Conceiving?

Your doctor can explain which tests you may need before conceiving. This may include:

• Kidney function tests
• Blood pressure tests
• Tests to evaluate whether there’s any protein in your urine

Based on the results of these tests and your medical history, your doctor may be able to pinpoint possible risks early. They can work with the rest of your care team to reduce these risks and make pregnancy safer.

Your OB-GYN or urologist may also perform additional testing. They can explain whether egg or sperm count and quality may affect your fertility.

Should I Consider Fertility Preservation or Assisted Reproduction?

If pregnancy is not safe or possible right now, your doctor may refer you to a fertility specialist to discuss other options. A fertility doctor can help you decide whether fertility preservation or assisted reproduction may be right for you.

For example, in vitro fertilization (IVF) may be recommended for some people. During IVF, eggs are fertilized with sperm outside the body, and an embryo is placed in the uterus.

In other cases, eggs, sperm, or embryos can be frozen and stored at a fertility clinic. This may give you more time for your CKD to become stable before trying to get pregnant. Because fertility care can be expensive, ask your health insurer what your plan covers.

Join the Conversation

On MyKidneyDiseaseTeam, people share their experiences with kidney disease, get advice, and find support from others who understand.

Have you gotten medical advice about fertility while living with C3G or IC-MPGN? Let others know in the comments below.