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Maintaining Testosterone Therapy Throughout Ovarian Stimulation for Trans Masculine Individuals: A Systematic Review
Gabriela Leon1, Dalia Karol1, Brenna Leslie2
1Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada.
LGBT Health
|April 2, 2026
Summary
Fertility preservation is possible for transgender individuals undergoing testosterone therapy. Oocyte and embryo cryopreservation, along with live births, demonstrate successful outcomes in this population.
Area of Science:
- Reproductive Endocrinology
- Transgender Health
- Fertility Preservation
Background:
- Continuous testosterone therapy is common for transgender individuals.
- Ovarian stimulation protocols in this population require careful consideration.
- Limited data exists on fertility outcomes during testosterone use.
Purpose of the Study:
- To systematically review evidence on continuous testosterone therapy during ovarian stimulation.
- To summarize fertility preservation outcomes in trans masculine individuals.
Main Methods:
- Systematic literature search across multiple databases (Medline, EMBASE, Cochrane, PubMed, CINAHL, Web of Science, ClinicalTrials.gov).
- Inclusion of studies reporting ovarian stimulation in patients on continuous testosterone therapy.
- Qualitative synthesis and descriptive statistics for data analysis.
Main Results:
- Review of six articles involving eight trans masculine patients.
- Median age for oocyte cryopreservation was 27 years.
- Successful oocyte and embryo cryopreservation reported, with live births following embryo transfer.
Conclusions:
- Fertility preservation, including live births, is achievable with various stimulation protocols under testosterone exposure.
- Current fertility care practices may need reevaluation to better support transgender individuals.
- A paradigm shift in fertility care for transgender individuals is proposed.
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