Kidney transplantation improve semen quality in patients with dialysis: A systematic review and meta-analysis

Kidney transplantation has been considered as the most effective therapy for patients with end-stage renal disease. However, less attention was attached to infertility. The present meta-analysis was conducted to compare the semen quality between patients with dialysis and patients after kidney transplantation. An extensive search in MEDLINE, PubMed and Web of Science was conducted from inception to March 2021. The data extracted for meta-analysis included sample size and characteristics, main reported outcomes like semen quality and hormone levels. For the semen quality and hormone levels, the standardized mean difference (SMD) and 95% confidential interval (CI) were calculated to evaluate the effect size. Finally, 5 studies were included in meta-analysis. Kidney transplantation could improve the sperm density of patients undergoing dialysis (SMD 1.58 [0.02, 3.15]). Additionally, the sperm motility was also improved after the kidney transplantation (SMD 3.26 [0.73, 5.79]). The sperm density of kidney transplantation patients was lower than that in healthy subjects (SMD -0.75 [-1.42, -0.07]), same as the sperm motility (SMD -0.50 [-0.80, -0.20]). Our meta-analysis suggests kidney transplantation could improve semen quality of patients with ESRD, including sperm density and sperm motility. Of note, semen quality of renal transplantation recipient still is inferior to healthy subjects.