Guidance Statements

Document Overview

Design and created by Guideline Central in participation with the American Association for the Study of Liver Diseases.

Reproductive Health and Liver Disease

American Association for the Study of Liver Diseases

Publication Date: Sep 17, 2020

Page Last Updated: May 5, 2026

Document Overview

Document Title: Reproductive Health and Liver Disease

Authoring Society: American Association for the Study of Liver Diseases

Document Publication Date: Sep 17, 2020

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: aasldpubs.onlinelibrary.wiley.com/doi/10.1002/hep.31559

Source Citation: Sarkar M, Brady CW, Fleckenstein J, Forde KA, Khungar V, Molleston JP, Afshar Y, Terrault NA. Reproductive Health and Liver Disease: Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology. 2020 Sep 18. doi: 10.1002/hep.31559. Epub ahead of print. PMID: 32946672.

Supplemental Implementation Resources

Quick-Reference Guide

Document Scope, Criteria, and Use Cases

Document Objectives: This first Practice Guidance on Reproductive Health from the American Association for the Study of Liver Diseases (AASLD) is intended to be a comprehensive reference on adolescents and adults with chronic liver disease. The Guidance specifically (1) addresses management of reproductive health in women and men from puberty to senescence and (2) summarizes the natural history, risk factors, evaluation, and optimal management of liver diseases during pregnancy and after birth.

Scope: Assessment and Screening, Management

Diseases/Conditions (MeSH)

D008107 - Liver Diseases

D060728 - Reproductive Health

D016031 - Liver Transplantation

D008107 - Liver Diseases

D060728 - Reproductive Health

D016031 - Liver Transplantation

Keywords: Reproductive Health, liver disease

Inclusion Criteria: Male, Female, Adolescent, Adult

Health Care Settings: Ambulatory

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Number of Source Documents: 456

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: No

Reproductive Health and Liver Disease

Guidance Statements

Sexual Function Across Age in Patients with Chronic Liver Disease

Evaluation and Management of Sexual Dysfunction in Chronic Liver Disease

Pregnancy Planning in Adolescents and Adults With Liver Conditions

Assisted Reproduction and Liver Disease

Menopause, Andropause, and Hormone Therapy

Evaluation of Liver Disease in Pregnancy

Initial Evaluation of a Pregnant Patient With Liver Disease

Liver Biochemistry Changes During Normal Pregnancy

Abdominal Imaging in Pregnancy

Management of Chronic Liver Diseases During Pregnancy and Lactation

Hepatitis B

HBsAg‐positive pregnant women:

Hepatitis C

Wilson Disease

In women with WD:

Autoimmune Hepatitis

In women with AIH:

Chronic Cholestatic Liver Diseases

Primary Biliary Cholangitis and Primary Sclerosing Cholangitis

In women with PBC and PSC:

Nonalcoholic Fatty Liver Disease

In reproductive‐aged patients with NAFLD:

In pregnant patients with NAFLD:

Alcohol‐Associated Liver Disease

Liver Conditions Requiring Special Management in Pregnancy

Benign Hepatic Lesions in Pregnancy

Hepatocellular Adenomas

Hepatic Hemangiomas

Focal Nodular Hyperplasia

Budd‐Chiari Syndrome

Gallstone Disease in Pregnancy

Acute Viral Hepatitis

Pregnancy in the Patient With Cirrhosis

Management of portal hypertension (PHT) in Pregnancy

Liver Diseases Unique to Pregnancy and Their Management

Hyperemesis Gravidarum

Intrahepatic Cholestasis of Pregnancy

Hypertensive Diseases of Pregnancy

Acute Fatty Liver of Pregnancy

Reproductive Health and Pregnancy in Transplant Recipients

Document Overview

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Recommendation Development Processes & Methodology