Fertility preservation is one of the best options for future reproductive
possibilities; however, it is often underutilized. In a survey of 121
transwomen, 51% would have strongly considered or undergone sperm cryopreservation
if they have been given the option by a provider (source and
study).
To better understand what fertility preservation entails, here’s
what you need to know:
For bodies that make sperm: A sperm sample will be collected, whether through ejaculation, testicular
extraction, or electroejaculation (EEJ). The sample is then frozen and
stored (cryopreservation) off-site, until it is able to be thawed and
used via IUI, IVF, or at-home insemination.
For bodies with a uterus: Estrogen-based hormones will need to be taken to stimulate ovaries to
produce multiple eggs. Once ready for retrieval, the eggs are extracted,
frozen and stored (cryopreservation), until ready for use in the future.
If you are reading this and did not preserve your fertility prior to gender-affirming
medical or surgical treatments, do not lose hope. Each person and circumstance
is unique, so your best next step is to
schedule an appointment with one of our reproductive endocrinologists to understand the options
available to you.
Treatment
Fertility Treatment Options for People Assigned Female at Birth
However, if an individual has decided to undergo surgery to remove their
ovaries and did not preserve their eggs beforehand, fertility will be
compromised.
During your appointment, an ACRM reproductive endocrinologist will walk
you through your reproductive options, which may include:
Unassisted conception with a partner.
IUI, with sperm from a partner or a donor.
IVF, with sperm from a partner or a donor, or by providing eggs to a partner.
There are additional things to consider when deciding whether or not to
move forward with fertility treatment — for example, the emotional
and physical effects of going off testosterone, and hormones and lactation
(chest feeding) during the postpartum period. We are here to help guide
and support you through this process.
Fertility Treatment Options for People Assigned Male at Birth
Unfortunately, there is very little data about the effects of estrogen
on sperm production. In some cases, individuals are able to produce sperm
after coming off estrogen, while others may experience permanent damage
in sperm production.
Additionally, if an individual has undergone “bottom surgery,”
or removal of the testicles, and did not preserve their sperm beforehand,
fertility will be compromised.
During your appointment, an ACRM reproductive endocrinologist will walk
you through your reproductive options, which may include:
Unassisted conception with a partner.
IUI with a partner who has a uterus.
IVF with a partner who has a uterus or gestational carrier.
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