First Healthy Live Birth Achieved Through Assisted Reproductive Technologies in Türkiye After Lung Transplantation: A...

Pregnancy after lung transplantation is uncommon and presents significant challenges due to chronic immunosuppression, infection risk, and potential graft dysfunction. We report a 35-year-old woman, 5 years postcadaveric bilateral lobar lung transplantation for non-cystic fibrosis bronchiectasis, who presenting with primary infertility and diminished ovarian reserve. Mycophenolate mofetil was discontinued because of teratogenic risk, and immunosuppression with tacrolimus and prednisolone was continued. Following an unsuccessful assisted reproductive technology (ART) attempt at another center and a second failed cycle complicated by post-transfer pulmonary infection, a third ART cycle was initiated using individualized ovarian stimulation. Piezo-assisted intracytoplasmic sperm injection yielded 3 blastocysts, and preimplantation genetic testing for aneuploidy (PGT-A) identified one euploid embryo. Infection control during treatment was guided by serial C-reactive protein monitoring and close clinical surveillance. A modified natural-cycle frozen embryo transfer resulted in a singleton pregnancy. At 30 weeks, the patient developed hypertension and pneumonia, both managed medically without intensive care. Due to declining pulmonary function, an elective cesarean delivery was performed at 35 weeks and 4 days, resulting in the birth of a healthy male infant (2190 g, Apgar score 10). Both mother and newborn were discharged in good condition, and the patient's pulmonary function improved postpartum with an uneventful follow-up during the past 6 months. This case represents the first documented live birth in Türkiye achieved through ART and PGT-A in a lung transplant recipient and demonstrates that successful pregnancy outcomes are attainable with coordinated multidisciplinary management and individualized reproductive planning.