术前月经失调（闭经、月经量少、不规则出血等)，术后8-9个月后可以恢复正常。肝移植术后怀孕生育也时有报道[49]。有人认为，肝移植术后女性完全可以恢复正常的生育能力，但早产和剖宫产的概率较高。在怀孕期间，免疫抑制应该正常使用，但要注意监测。至目前为止，还没有致畸的报道。怀孕及生育不会增加排异反应的危险[50]。由于口服避孕药会增加血液粘稠度，加重高血压及药物之间的反应，故肝移植术后病人不宜使用口服避孕药。
肝移植术后对男性生育能力的影响还未见报道。由于肝移植病人的下一代均未到生育年龄，因此对下一代生育能力有无影响也未见报道。
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