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Fertility considerations in transgender patients
Betty Wang1, Ross Hengel, Runhan Ren
1Division of Urology, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
Current Opinion in Urology
|March 25, 2020
Summary
Fertility preservation for transgender women is advancing, but uptake remains low due to age and access barriers. Sperm cryopreservation is key, with new research showing promise for prepubertal patients.
Area of Science:
- Reproductive Medicine
- Transgender Health
- Oncofertility
Background:
- Fertility preservation services for transgender individuals are expanding.
- Referral rates for fertility preservation remain low (13.5% in 2018).
- Patients are transitioning at younger ages, impacting fertility preservation timing.
Purpose of the Study:
- To review advances in fertility preservation for transgender women.
- To emphasize attitudes, access, and techniques.
- To identify barriers to uptake.
Main Methods:
- Review of recent literature on fertility preservation techniques.
- Analysis of trends in transgender healthcare access.
- Discussion of assisted reproductive technologies.
Main Results:
- Sperm cryopreservation before hormonal therapy is the primary method.
- Assisted reproductive technologies (IUI, IVF/ICSI) are used based on sperm availability.
- Successful autologous grafting of cryopreserved prepubertal testis in macaques offers future possibilities.
Conclusions:
- Despite increased accessibility, low referral and usage rates persist.
- Barriers to fertility preservation for transgender women need to be addressed.
- Clinicians should counsel patients and advocate for reduced financial and infrastructural obstacles.
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