[Fertility preservation for trans men: Barriers and motivations]

Given the low proportion of trans men (individuals assigned female at birth-FtX) opting for oocyte preservation despite systematic information, this study aimed to identify their motivations and barriers within a gender transition pathway at Lille University Hospital.

TRANSPF is an observational, cross-sectional, single-center study including adult FtX individuals seen for fertility preservation consultation between May 2018 and May 2024. An online questionnaire, approved by an ethics committee, collected demographic data, information on care pathways, knowledge, motivations, and barriers. Statistical analysis was mainly descriptive, performed using JAMOVI.

Among the 362 FtX individuals seen, only 31 (8.5%) underwent oocyte cryopreservation-a rate below the national average. Of the 221 people contacted, 67 complete questionnaires were analyzed (response rate: 30%, mean age: 23). While 82% were aware of the possibility of preserving fertility, technical knowledge remained limited. The main motivation for preservation was the potential use of the ROPA method (Reception of Oocytes from the Partner) (45%). Reported barriers included the need to interrupt androgen therapy (45%), the transvaginal retrieval method (46%), the burdensome nature of the protocol (37%), and fear of poor medical reception (31%).

Clear, inclusive, and up-to-date information on fertility preservation is essential. Psychological, technical, and legal barriers must be more thoroughly addressed within care pathways. Greater healthcare provider training and broader bioethical reflection-particularly regarding trans parenthood and post-transition use of gametes-are necessary to improve access to fertility options for trans individuals.