Reproductive functions and fertility preservation in transgender women: a French case series

REPRODUCTIVE BIOMEDICINE ONLINE

卷:43

Article

Sermondade, Nathalie^1,2  Benaloun, Emmanuelle¹  Berthaut, Isabelle¹  Moreau, Emilie¹  Prades, Marie¹  Beranger, Alix¹  Chabbert-Buffet, Nathalie³  Johnson, Nicolai³  Levy, Rachel^1,2  Dupont, Charlotte^1,2 

[1] Sorbonne Univ, Hop Tenon, AP HP, Serv Biol Reprod CECOS, F-75012 Paris, France

[2] Sorbonne Univ, Ctr Rech St Antoine, Inserm US938, F-75012 Paris, France

[3] Sorbonne Univ, Hop Tenon, AP HP, Serv Gynecol Obstet & Med Reprod, F-75020 Paris, France

关键词: Fertility preservation;    Semen parameters;    Sperm cryopreservation;    Transgender woman;    Trans identity;   

DOI  :  10.1016/j.rbmo.2021.04.016

来源: Elsevier

【 摘 要 】

Research question: The reproductive potential of transgender people may be impaired by gender-affirming hormone treatment (GAHT) and is obviously suppressed by gender-affirming surgery involving bilateral orchiectomy. The evolution of medical support for transgender people has made fertility preservation strategies possible. Fertility preservation in transgender women mainly relies on sperm cryopreservation. There are few studies on this subject, and the sample sizes are small, and so it difficult to know whether fertility preservation procedures are feasible and effective in trans women. Design: This retrospective study reports the management of fertility preservation in transgender women referred to the study centre for sperm cryopreservation, and the semen parameters of trans women were compared with those of sperm donors. Results: Ninety-six per cent of transgender women who had not started treatment benefitted from sperm cryopreservation, compared with 80% of those who attempted a therapeutic window and 50% of those receiving hormonal treatment at the time of sperm collection. No major impairment of semen parameters was observed in transgender women who had not started GAHT compared with sperm donors. However, even though the frequency of oligozoospermia was no different, two transgender women presented azoospermia. Some transgender women who had started GAHT could benefit from sperm freezing. None of them were treated with gonadotrophin-releasing hormone (GnRH) analogues. Conclusions: Parenthood strategies for transgender people have long been ignored, but this is an important issue to consider, especially because medical treatments and surgeries may be undertaken in adolescents or very young adults. Fertility preservation should ideally be offered prior to initiation of GAHT.

【 授权许可】

Free