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Low total motile sperm in transgender women seeking hormone therapy.
J Assist Reprod Genet 2019; 36(8):1639-1648JA

Abstract

PURPOSE

This study was undertaken to compare semen quality, hormonal status, and social factors in transgender women seeking fertility preservation with those of fertile cisgender men. Long-range goals are to establish standard practice measures ensuring optimum semen quality for cryopreservation and fertility preservation in transgender women.

METHODS

This is a case-control study carried out at an academic medical center. Cases are transgender women seeking fertility preservation prior to initiation of hormone therapy. Controls are cisgender men recently fathering a child. All participants completed the Depression Anxiety Stress Scales 21 survey and additional survey questions related to personal behaviors. Complete semen analysis was carried out in a clinical andrology laboratory according to WHO guidelines, 5th edition. Serum follicle stimulating hormone, estradiol, and testosterone were measured at the time of semen analysis.

RESULTS

Sperm concentration, total sperm per ejaculate, total motile sperm, volume, and normal sperm morphology were significantly lower in transgender females compared with fertile cisgender men. Other measures of semen parameters and hormone concentrations were not different between groups. Survey results indicated transgender women were more likely to have symptoms of depression, anxiety, and stress and utilize tucking and tight undergarments, compared with controls; however, both groups reported similar numbers of ejaculations per week.

CONCLUSIONS

Although semen parameters were low, cryopreservation of sperm prior to hormone therapy is a viable fertility preservation option for most transgender women. The etiology of the differences in semen parameters is not known. Enhanced education related to personal behaviors or treatment to reduce effects of stressors prior to cryopreservation may improve future fertility potential.

Authors+Show Affiliations

Department of Obstetrics & Gynecology, University of Kansas Medical Center, Kansas City, KS, 66160, USA. cmarsh2@kumc.edu. Center for Advanced Reproductive Medicine, University of Kansas Medical Center, Overland Park, KS, 66211, USA. cmarsh2@kumc.edu. Institute for Reproduction and Perinatal Health, University of Kansas Medical Center, Kansas City, KS, 66160, USA. cmarsh2@kumc.edu.Department of Obstetrics & Gynecology, University of Kansas Medical Center, Kansas City, KS, 66160, USA. Center for Advanced Reproductive Medicine, University of Kansas Medical Center, Overland Park, KS, 66211, USA.Department of Obstetrics & Gynecology, University of Kansas Medical Center, Kansas City, KS, 66160, USA.Institute for Reproduction and Perinatal Health, University of Kansas Medical Center, Kansas City, KS, 66160, USA. Department of Urology, University of Kansas Medical Center, Kansas City, KS, 66160, USA.Department of Obstetrics & Gynecology, University of Kansas Medical Center, Kansas City, KS, 66160, USA. Center for Advanced Reproductive Medicine, University of Kansas Medical Center, Overland Park, KS, 66211, USA.Department of Obstetrics & Gynecology, University of Kansas Medical Center, Kansas City, KS, 66160, USA. kroby@kumc.edu. Center for Advanced Reproductive Medicine, University of Kansas Medical Center, Overland Park, KS, 66211, USA. kroby@kumc.edu. Institute for Reproduction and Perinatal Health, University of Kansas Medical Center, Kansas City, KS, 66160, USA. kroby@kumc.edu. Department of Anatomy & Cell Biology, University of Kansas Medical Center, Kansas City, KS, 66160, USA. kroby@kumc.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31250175

Citation

Marsh, Courtney, et al. "Low Total Motile Sperm in Transgender Women Seeking Hormone Therapy." Journal of Assisted Reproduction and Genetics, vol. 36, no. 8, 2019, pp. 1639-1648.
Marsh C, McCracken M, Gray M, et al. Low total motile sperm in transgender women seeking hormone therapy. J Assist Reprod Genet. 2019;36(8):1639-1648.
Marsh, C., McCracken, M., Gray, M., Nangia, A., Gay, J., & Roby, K. F. (2019). Low total motile sperm in transgender women seeking hormone therapy. Journal of Assisted Reproduction and Genetics, 36(8), pp. 1639-1648. doi:10.1007/s10815-019-01504-y.
Marsh C, et al. Low Total Motile Sperm in Transgender Women Seeking Hormone Therapy. J Assist Reprod Genet. 2019;36(8):1639-1648. PubMed PMID: 31250175.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low total motile sperm in transgender women seeking hormone therapy. AU - Marsh,Courtney, AU - McCracken,Megan, AU - Gray,Meredith, AU - Nangia,Ajay, AU - Gay,Judy, AU - Roby,Katherine F, Y1 - 2019/06/26/ PY - 2018/12/13/received PY - 2019/06/11/accepted PY - 2020/08/01/pmc-release PY - 2019/6/30/pubmed PY - 2019/6/30/medline PY - 2019/6/29/entrez KW - Fertility preservation KW - Semen analysis KW - Transgender SP - 1639 EP - 1648 JF - Journal of assisted reproduction and genetics JO - J. Assist. Reprod. Genet. VL - 36 IS - 8 N2 - PURPOSE: This study was undertaken to compare semen quality, hormonal status, and social factors in transgender women seeking fertility preservation with those of fertile cisgender men. Long-range goals are to establish standard practice measures ensuring optimum semen quality for cryopreservation and fertility preservation in transgender women. METHODS: This is a case-control study carried out at an academic medical center. Cases are transgender women seeking fertility preservation prior to initiation of hormone therapy. Controls are cisgender men recently fathering a child. All participants completed the Depression Anxiety Stress Scales 21 survey and additional survey questions related to personal behaviors. Complete semen analysis was carried out in a clinical andrology laboratory according to WHO guidelines, 5th edition. Serum follicle stimulating hormone, estradiol, and testosterone were measured at the time of semen analysis. RESULTS: Sperm concentration, total sperm per ejaculate, total motile sperm, volume, and normal sperm morphology were significantly lower in transgender females compared with fertile cisgender men. Other measures of semen parameters and hormone concentrations were not different between groups. Survey results indicated transgender women were more likely to have symptoms of depression, anxiety, and stress and utilize tucking and tight undergarments, compared with controls; however, both groups reported similar numbers of ejaculations per week. CONCLUSIONS: Although semen parameters were low, cryopreservation of sperm prior to hormone therapy is a viable fertility preservation option for most transgender women. The etiology of the differences in semen parameters is not known. Enhanced education related to personal behaviors or treatment to reduce effects of stressors prior to cryopreservation may improve future fertility potential. SN - 1573-7330 UR - https://www.unboundmedicine.com/medline/citation/31250175/Low_total_motile_sperm_in_transgender_women_seeking_hormone_therapy_ L2 - https://doi.org/10.1007/s10815-019-01504-y DB - PRIME DP - Unbound Medicine ER -