Background: Discordance between gonadal type and gender identity has often led to an assumption of infertility in patients with differences in sex development (DSD). However, there is now greater recognition of fertility being an important issue for this group of patients. Currently, gonadal tissue that may have fertility potential is not being stored for individuals with DSD and, where gonadectomy forms part of management, is often discarded. The area of fertility preservation has been predominantly driven by oncofertility which is a field dedicated to preserving the fertility of patients undergoing gonadotoxic cancer treatment. The use of fertility preservation techniques could be expanded to include individuals with DSD where functioning gonads are present.
Methods: This is a systematic literature review evaluating original research articles and relevant reviews between 1974 and 2018 addressing DSD and fertility, in vitro maturation of sperm, and histological/ultrastructural assessment of gonadal tissue in complete and partial androgen insensitivity syndrome, 17β-hydroxysteroid dehydrogenase type 3 and 5α-reductase deficiency.
Conclusion: Successful clinical outcomes of ovarian tissue cryopreservation are paving the way for similar research being conducted using testicular tissue and sperm. There have been promising results from both animal and human studies leading to cryopreservation of testicular tissue now being offered to boys prior to cancer treatment. Although data are limited, there is evidence to suggest the presence of reproductive potential in the gonads of some individuals with DSD. Larger, more detailed studies are required, but if these continue to be encouraging, individuals with DSD should be given the same information, opportunities and access to fertility preservation as other patient groups.
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http://dx.doi.org/10.1111/cen.13994 | DOI Listing |
Sci Rep
December 2024
Centre of Excellence in Clinical Embryology, Department of Reproductive Science, Kasturba Medical College, Manipal. Manipal Academy of Higher Education, Manipal, 576 104, India.
Cyclophosphamide (CY) exposure is known to affect the ovary and impair fertility. Clinically, treatment is generally given over multiple doses, but research models have generally used single doses. The relative effects of administering multiple small doses of CY in the prepubertal period are not elucidated.
View Article and Find Full Text PDFInt J Gynaecol Obstet
December 2024
Department of Surgery, Division of Urology, Human Reproduction Section, São Paulo Federal University (UNIFESP), São Paulo, Brazil.
Transgender people have been experiencing significant advancements in their social visibility, although they continue to face frequent discrimination and exclusion. Among the issues encompassing transgender individuals' health care, the right to reproductive and sexual health have gained traction in the study landscape, necessitating an exploration of fertility preservation options for these patients. This report sheds light on the process of cryopreserving gametes and ovarian tissue after total hysterectomy with bilateral salpingo-oophorectomy for gender reassignment in a transgender man in hormonal masculinization.
View Article and Find Full Text PDFEur J Obstet Gynecol Reprod Biol
December 2024
Sperm Bank & Andrology Unit, Shamir Medical Center, Zerifin, Israel; IVF Department, Shamir Medical Center, Zerifin, Israel; Sackler Medical School, Tel Aviv University, Tel Aviv, Israel.
Objectives: This study investigates sperm utilization and disposal patterns in Oligoasthenoteratozoospermia (OAT) patients undergoing long-term sperm storage. OAT is a major contributor to male infertility. Cryopreservation is a common practice as a "fertility insurance" in case of further deterioration until azoospermia.
View Article and Find Full Text PDFReprod Biomed Online
October 2024
Virginia Center for Reproductive Medicine, Reston, VA, USA; Department of Obstetrics and Gynecology, George Washington University, Washington, DC, USA. Electronic address:
Research Question: How safe and effective is transrectal oocyte retrieval (TROR) for fertility preservation in nulliparous virginal women?
Design: This was a retrospective single-centre study of 105 nulliparous women from five satellite centres of Fakih IVF, UAE, who underwent TROR for oocyte cryopreservation. Extensive bowel preparation and rectal cleansing was performed prior to oocyte retrieval. Patient characteristics, stimulation protocol, and procedure outcome and safety data were collected.
Fertil Steril
December 2024
Northwestern University Feinberg School of Medicine, Department of Urology, 675 N St. Clair St, Chicago, IL, USA.
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