Oocyte Cryopreservation in Transgender and Gender-Diverse Individuals With or Without Prior Testosterone Use

Area of Science:

• Reproductive Endocrinology
• Gender-Affirming Care
• Oncology

Background:

• Fertility preservation is crucial for transgender and gender-diverse individuals undergoing gender-affirming care.
• Testosterone therapy can impact reproductive potential, necessitating evaluation of oocyte cryopreservation outcomes.

Purpose of the Study:

• To assess the feasibility and outcomes of oocyte cryopreservation in transgender and gender-diverse adolescents and young adults.
• To compare oocyte cryopreservation success rates between individuals with and without prior testosterone exposure.

Main Methods:

• Retrospective cohort study of patients under 35 years undergoing oocyte cryopreservation (2014-2023).
• Analysis included patients referred for fertility preservation, distinguishing between testosterone-naïve and testosterone-exposed groups.
• Key outcomes measured were the number of oocytes retrieved and mature oocytes frozen.

Main Results:

• The number of patients pursuing fertility preservation increased annually.
• No significant difference was observed in the number of oocytes retrieved (median 28 vs 32) or mature oocytes frozen (21 vs 21) between testosterone-naïve and testosterone-exposed groups.
• Neither duration of testosterone use nor time off testosterone (minimum 2 months) affected the number of mature oocytes frozen.

Conclusions:

• Oocyte cryopreservation is a successful fertility preservation option for transgender and gender-diverse individuals, irrespective of prior testosterone exposure.
• Testosterone therapy does not appear to negatively impact oocyte yield or quality for cryopreservation.
• This study supports offering oocyte cryopreservation as a standard fertility preservation option for this population.