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Fertility Preservation For Transgender People

If you are transgender and undergoing gender transition or about to, it can add another level of complexity when it comes to fertility treatments. How you should approach these depends on any hormonal or surgical changes you have had in the past or are planning on undergoing. Some hormone therapies or surgeries may have an impact on your future fertility and it’s important to know what options are available to you, whether you’re thinking of having children soon or want to improve your chances later down the line1.

First, we’re going to discuss fertility preservation for anyone who wants to preserve their fertility before undergoing gender reassignment procedures.

Fertility preservation refers to egg, sperm, embryo or reproductive tissue freezing for use in future fertility treatment2. They can be stored for up to 55 years, but you have to renew your consent every 10 years. In order to proceed with fertility preservation, you are likely to have to stop any hormone therapy you’re currently undergoing. Hence, it’s important to discuss your options with a fertility specialist early on.

Freezing eggs for trans men

Egg freezing involves taking fertility drugs to stimulate your ovaries to produce multiple eggs. The eggs are then collected in a surgical procedure whilst you’re under sedation. The eggs are checked for maturity, frozen and stored in cryo tanks3.

Freezing ovarian tissue for trans men

If you’re ready for genital reconstructive surgery, it may be possible for your surgeon to collect ovarian tissue during the surgery, which can be frozen and stored for future fertility treatments. When you’re ready to use it, the tissue would be re-implanted in order to restore ovarian hormone function and egg production. It’s worth noting that this procedure is usually only offered to patients under the age of 35 and it is currently only offered in three UK centres: Guy’s Hospital, Oxford and Edinburgh.

Freezing sperm for trans women

Sperm freezing involves masturbating or undergoing vibratory stimulation to produce a sperm sample. The sample is then frozen, often in multiple small storage devices and stored in cryo tanks4. It may require multiple deposits to obtain a sufficient amount of sperm for storage.

Freezing surgically retrieved sperm for trans women

If you’re ready for genital reconstructive surgery, it may be possible for your surgeon to collect sperm or testicular tissue through the surgery which can be frozen and stored in cryo tanks.

Now, we can explore the future fertility treatment that may be used when you’re ready to have children.

If you have frozen eggs or sperm stored at a fertility clinic, you can use them in a fertility treatment to have children. This will likely be through IVF, which you can read more about here.
For trans men, the treatment pathways will differ depending on whether you wish to carry a pregnancy or whether you decide to have a partner or surrogate carry the pregnancy. Your frozen eggs can be thawed in the laboratory and used with sperm from a partner or donor.
For trans women, the treatment pathway will differ depending on whether your partner or a surrogate will carry the pregnancy. Your frozen sperm can be thawed in the laboratory and used with eggs from a partner or donor.

Additional information

Having children may not be on your mind right now, but it could be helpful to discuss the topic with other trans people who have been in your position. The Gender Identity Development Service can discuss fertility with you, and your family members should you wish.

Learn more:

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