Infertility and Quality of Life in Women with CKD: A Case Control Study

Parenthood and pregnancy are important life goals for many individuals, including those with CKD. However, fertility concerns and their impact on quality of life (QoL) are often overlooked in people with complex medical needs. The Fertility QoL (FertiQoL) questionnaire is a validated tool that assesses fertility-related QoL across six domains. This study aimed to assess FertiQoL in women with CKD compared to healthy control women of reproductive age.

We conducted a case-control study including 102 women with CKD and 84 healthy controls. Participants completed the FertiQoL survey during a study visit. Domain and total scores were compared between groups, with subgroup analyses among women with prior fertility treatment, those actively trying to conceive, and nulliparous women. Findings were reviewed with an independent expert patient group of women with CKD to evaluate result interpretation and co-develop recommendations.

Women with CKD and controls were similar in age, BMI, parity and history of conception attempts. Median total scaled FertiQoL score was significantly higher in women with CKD than healthy controls (66.2 [IQR 54.8-77.8] vs. 56.6 [IQR 50.5-64.1]; p < 0.001). Women with CKD also had significantly higher scores in emotional, mind-body and social domains. However, among women with prior fertility treatment or those actively trying to conceive, fertility-related QOL did not differ significantly by CKD status. The expert patient group suggested these findings were an adaptation to the demands of long-term ill health rather than any underlying differences in reproductive aspirations.

This is the first study to assess fertility-related QoL in CKD. Women with CKD reported comparable or better fertility-related quality of life than controls, likely reflecting adaptation to chronic illness. Fertility remains a key priority for women with CKD, highlighting the need for proactive, multidisciplinary fertility counselling and access to reproductive care.