Posted on June 24th, 2019by Dr. Lawrence Grunfeldin Fertility Preservation

Fertility Preservation Options for the Transgender Community

If you identify as a member of the transgender community you can still have a genetic child and undergo a gender affirming transition. There are fertility preservation options readily available for the transgender community that will allow you to preserve your sperm or eggs to build a family in the future.

Reproductive care in the transgender community is based on the body parts you have. If you possess testes, you can preserve sperm and if you have ovaries, you can preserve eggs.

Sperm Preservation
Since the testes are the production site of sperm, you need to obtain and store sperm for future use prior to genital surgery. There are several ways to obtain sperm for cryopreservation. If you are able to ejaculate, sperm can be collected directly from the ejaculation and cryopreserved. If ejaculation is not possible, but your testes function and are unobstructed, sperm can be collected under anesthesia with electroejaculation – a procedure in which an electrical probe stimulates contraction of your pelvic muscles and, eventually, ejaculation. Even if your testes are obstructed there are procedures to collect sperm directly from the testes. Percutaneous testicular sperm extraction (TESE) retrieves biopsies of the testes that can be frozen for future reproductive technologies. This procedure is performed with minimal invasiveness under IV sedation. If you are taking medications that block testosterone, these can inhibit sperm production. You may need to discontinue these medications for 3-6 months prior to sperm harvesting to get ideal sperm counts.

Egg Preservation
If you have ovaries, you can choose to preserve your eggs for future reproductive use prior to undergoing surgery. Egg collection is done under IV sedation through the vagina using ultrasound guidance. You are primed with 2 weeks of fertility hormones to mature as many eggs as can be retrieved in one artificial ovulation cycle. This technique does not require normal menstrual cycles, but you are expected to menstruate once at the end of the procedure. If you are taking testosterone, you may have to discontinue taking the medication 3-6 months prior to harvesting your eggs in order to get ideal egg maturity. You can resume testosterone as soon as the collection is complete.

At RMA of New York, we will perform these fertility preservation procedures on individuals over 80 pounds who are 12 years or older. It is our hope that fertility preservation will become an important discussion among the transgender community. Everyone deserves the opportunity to become a parent and fertility preservation options now enable members of the transgender community to have genetically-related children of their own

RMA provides a transgender friendly healthcare. All members of our practice greet transgender patients by their preferred name and pronouns and are sensitive to the needs of the community.

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