Egg freezing in transgender men

Transgender men are people who were biologically assigned female at birth but identify as men. It is important to consider the impacts of testosterone and reassignment surgery on fertility. Hormone therapy can compromise ovarian function, and surgery can result in the irreversible loss of reproductive capacity. Fertility preservation has emerged as a viable option for those who wish to have biological children. This study aimed to evaluate the effectiveness of this method in trans men, analyze the ovarian response to hormonal stimulation, and investigate the impact of the duration of therapy on the quality and quantity of oocytes. PubMed, SciELO, and LILACS databases were consulted, with articles from 2015 to 2025 in English, Portuguese, and Spanish, following the PRISMA guide. The data was organized in Microsoft Excel tables. Case, cohort, cross-sectional, prospective, and retrospective studies were included, excluding articles out of scope, unavailable, used animals, and reviews. Initially, 404 articles were identified, with four duplicates excluded. After screening, 25 articles remained for full reading, of which 13 were analyzed. The duration of hormone therapy varied between 2 and 12 years among the patients in the studies analyzed, and only one patient did not have sufficient data due to the absence of embryo transfer. The studies showed promising results for egg cryopreservation, even with prolonged use of testosterone, but there are still no definitive conclusions about the long-term effect on fertility. This review contributes to the understanding of fertility in trans men and their reproductive alternatives.