Fertility preservation options for transgender individuals

Area of Science:

• Reproductive Endocrinology
• Transgender Health
• Medical Ethics

Background:

• Gender-affirming treatments can impact reproductive potential.
• Historically, genital gender-affirming surgery often precluded fertility.
• Fertility preservation (FP) counseling is recommended before transition but is inconsistently practiced.

Purpose of the Study:

• To review current and future fertility preservation options for transgender individuals.
• To identify barriers to FP treatment faced by patients.
• To examine healthcare provider practices and counseling protocols regarding FP for transgender patients.

Main Methods:

• Systematic literature search of PubMed, Medline, and Google Scholar.
• Identification of current and emerging FP techniques.
• Analysis of patient-reported barriers and provider practices.

Main Results:

• FP options for transwomen include semen banking and experimental testicular cryopreservation.
• Transmen can utilize standard assisted reproductive technologies available for ciswomen.
• Future options like ovarian tissue cryopreservation are under investigation.
• Patients face difficulties accessing FP due to lack of provider dialogue and information.
• Providers require better educational tools and training on transgender health and FP.

Conclusions:

• Comprehensive fertility preservation counseling is essential for all transgender individuals before initiating medical or surgical transition.
• Addressing provider education gaps and standardizing counseling protocols can improve access to and utilization of FP options.
• Informed decision-making requires prospective advice on FP requirements, costs, risks, and available technologies.