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Fertility preservation options for transgender and gender-nonconforming individuals.
Curr Opin Obstet Gynecol 2019; 31(3):170-176CO

Abstract

PURPOSE OF REVIEW

To provide an overview of the current state of knowledge of fertility risks of gender-affirming therapy, review fertility preservation options for transgender individuals and ways to minimize gender dysphoria during fertility treatment, and identify gaps in knowledge.

RECENT FINDINGS

Recent studies have corroborated older data that gender-affirming hormone therapy creates histopathological changes in the gonads; however, the newer data suggests that some function of the gametes may be preserved. One study in transgender men reported successful in-vitro maturation of testosterone-exposed oocytes with normal spindle structures, and recent studies in transgender women reveal early spermatogenesis in estradiol-exposed testes and some recovery of semen parameters following cessation of hormones. Particular attention has recently been given to fertility preservation in transgender adolescents, revealing unmet informational needs in this population and very few are actually pursuing fertility preservation, even with counseling.

SUMMARY

There is currently a paucity of data on the fertility effects of gender-affirming hormones, necessitating fertility preservation counseling prior to initiation of therapy. Several modifications can be made to fertility preservation protocols and procedures to decrease gender dysphoria or distress in transgender individuals, but outcome data is still lacking. Achieving high-quality data collection will likely require cooperation across multiple institutions.

Authors+Show Affiliations

Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30870185

Citation

Moravek, Molly B.. "Fertility Preservation Options for Transgender and Gender-nonconforming Individuals." Current Opinion in Obstetrics & Gynecology, vol. 31, no. 3, 2019, pp. 170-176.
Moravek MB. Fertility preservation options for transgender and gender-nonconforming individuals. Curr Opin Obstet Gynecol. 2019;31(3):170-176.
Moravek, M. B. (2019). Fertility preservation options for transgender and gender-nonconforming individuals. Current Opinion in Obstetrics & Gynecology, 31(3), pp. 170-176. doi:10.1097/GCO.0000000000000537.
Moravek MB. Fertility Preservation Options for Transgender and Gender-nonconforming Individuals. Curr Opin Obstet Gynecol. 2019;31(3):170-176. PubMed PMID: 30870185.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fertility preservation options for transgender and gender-nonconforming individuals. A1 - Moravek,Molly B, PY - 2019/3/15/pubmed PY - 2019/3/15/medline PY - 2019/3/15/entrez SP - 170 EP - 176 JF - Current opinion in obstetrics & gynecology JO - Curr. Opin. Obstet. Gynecol. VL - 31 IS - 3 N2 - PURPOSE OF REVIEW: To provide an overview of the current state of knowledge of fertility risks of gender-affirming therapy, review fertility preservation options for transgender individuals and ways to minimize gender dysphoria during fertility treatment, and identify gaps in knowledge. RECENT FINDINGS: Recent studies have corroborated older data that gender-affirming hormone therapy creates histopathological changes in the gonads; however, the newer data suggests that some function of the gametes may be preserved. One study in transgender men reported successful in-vitro maturation of testosterone-exposed oocytes with normal spindle structures, and recent studies in transgender women reveal early spermatogenesis in estradiol-exposed testes and some recovery of semen parameters following cessation of hormones. Particular attention has recently been given to fertility preservation in transgender adolescents, revealing unmet informational needs in this population and very few are actually pursuing fertility preservation, even with counseling. SUMMARY: There is currently a paucity of data on the fertility effects of gender-affirming hormones, necessitating fertility preservation counseling prior to initiation of therapy. Several modifications can be made to fertility preservation protocols and procedures to decrease gender dysphoria or distress in transgender individuals, but outcome data is still lacking. Achieving high-quality data collection will likely require cooperation across multiple institutions. SN - 1473-656X UR - https://www.unboundmedicine.com/medline/citation/30870185/Fertility_preservation_options_for_transgender_and_gender_nonconforming_individuals_ L2 - http://dx.doi.org/10.1097/GCO.0000000000000537 DB - PRIME DP - Unbound Medicine ER -