Women who have had a mechanical flap replaced can get pregnant if they are young women with fertility needs, there are just still some risks! There are different anticoagulation methods recommended for pregnant women with mechanical flaps. The method we recommend is to use warfarin anticoagulation throughout, keeping the anticoagulation index at the required low limit, as smooth as possible, and to use heparin replacement before waiting for delivery. Although there is some risk of teratogenicity, it reduces the risk of bleeding and maximizes the safety of the mother. Of course, only one approach is provided here, and its implementation requires a detailed treatment plan together with your OB/GYN and cardiac surgery specialist. The use of anticoagulants during pregnancy and childbirth is indeed a more problematic issue. Prior to cardiac surgery, we generally recommend the use of a biologic valve for women with childbearing requirements who require valve replacement. Although there is an age limit for the biologic valve and the need for a second procedure in younger patients, we believe that the risk of a second procedure is more manageable and acceptable to the patient than the risk of placental hemorrhage, intrauterine hemorrhage, and possible fetal malformations associated with warfarin administration during pregnancy and childbirth. Patients with sinus rhythm using a bioprosthetic valve have no effect on later pregnancy or childbirth as long as they become pregnant after stopping warfarin 3-6 months after the procedure. There is no effect on fertility in men taking warfarin.