AI Article Synopsis
- The study focuses on the impact of hormone therapy on fertility in transgender girls and emphasizes the need for counseling on fertility preservation prior to treatment.
- Eight out of 23 participants were able to provide sperm samples for cryopreservation, with all showing at least one secondary sex characteristic.
- The findings suggest that early referral for fertility preservation can lead to successful results, highlighting a significant proportion of transgender girls can preserve fertility despite undergoing puberty blockade.
Article Abstract
Background: Puberty blockade and gender-affirming hormone therapy can impair fertility. Counseling on fertility preservation is important before initiation of therapy. Our study aimed to assess Tanner staging and the presence of virilizing secondary sex characteristics at the time of sperm collection and correlate the viability of sperm with the Tanner staging and degree of virilization.
Methods: A retrospective chart review of 23 transgender girls referred to pediatric urology at our academic pediatric transgender clinic for fertility preservation counseling was performed. At the initial visit before treatment, pubertal staging along with the assessment of virilizing secondary characteristics was performed. The semen analyses were evaluated for volume, sperm concentration, total sperm count, motility, and total motile count.
Results: Of the first 23 transgender girls evaluated and counseled, 8 transgender females successfully produced a sperm sample for cryopreservation. The average testicular volume was 18.5 ml and ranged from 12 ml to 20 ml. The median semen parameters were at or above the 2021 World Health Organization threshold. The 8 transgender females who successfully underwent fertility preservation presented with at least 1 secondary sex characteristic. In 1 subject with Tanner stage 3 pubic hair development and a testicular volume of 12 ml, only voice change was reported. Facial hair and laryngeal prominence were not present on examination.
Conclusion: More than a third of our patients who accepted a referral to pediatric urology agreed to produce a sperm sample for cryopreservation. All of these patients successfully preserved sperm. With counseling and early referral to pediatric urology, a high percentage of fertility preservation in transgender girls was achieved.
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| http://dx.doi.org/10.1016/j.eprac.2024.01.008 | DOI Listing |
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Article Synopsis
- The cancer incidence rates among adolescents and young adults (AYA) have risen by 30% since 1970, highlighting the need for discussing fertility preservation (FP) before gonadotoxic treatments.
- National guidelines recommend various FP options like oocyte, embryo, and ovarian tissue cryopreservation, with significant progress in the practice of these options since 2013.
- Despite advancements and recommendations, the use of FP services is inconsistent, and factors affecting decision-making—like financial constraints—remain important concerns for patients.
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