Evidence of Spermatogenesis in the Presence of Hypothalamic Suppression and Low Testosterone in an Adolescent Transgender Female: A Case Report.

IF 2 4区医学 Q1 Social Sciences Transgender Health Pub Date : 2023-02-08 eCollection Date: 2023-02-01 DOI:10.1089/trgh.2021.0034

Amanda J Adeleye, Brett A Stark, Liza Jalalian, Evelyn Mok-Lin, James F Smith

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Abstract

Objective: To report a novel case of semen cryopreservation after testicular sperm extraction in an adolescent transgender female without cessation of gonadotropin-releasing hormone (GnRH) agonist therapy and feminizing hormone therapy.

Methods: This is a case report of a 16-year-old transgender female using leuprolide acetate for 4 years and estradiol for 3 years requesting semen cryopreservation at the time of gender-affirming orchiectomy. She desired to proceed without cessation of gender affirming hormone therapy. The patient's consent was obtained for written publication.

Results: The patient underwent testicular sperm extraction followed by orchiectomy. The sample was processed and cryopreserved in a 1:1 Test Yolk Buffer. Multiple early and late spermatids were identified as well as spermatagonium in the TESE specimen.

Conclusions: Advanced spermatogenesis may occur in the presence of a GnRH agonist. Cessation of GnRH agonist therapy may not be essential for semen cryopreservation in adolescent transgender females.

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一名青少年变性女性在下丘脑抑制和低睾酮状态下的精子发生证据：病例报告。

目的报告一例青少年变性女性在未停止促性腺激素释放激素（GnRH）激动剂治疗和女性化激素治疗的情况下进行睾丸取精后精液冷冻保存的新病例：本病例报告了一名 16 岁的变性女性，她使用醋酸亮丙瑞林 4 年，雌二醇 3 年，要求在进行确认性别的睾丸切除术时进行精液冷冻保存。她希望在不停止性别确认激素治疗的情况下进行手术。结果：患者接受了睾丸精子提取术和睾丸切除术。样本经处理后在 1:1 卵黄缓冲液中冷冻保存。在 TESE 标本中发现了多个早期和晚期精子以及精原细胞：结论：在使用 GnRH 促效剂的情况下，可能会出现高级精子发生。青少年变性女性的精液冷冻保存可能并不需要停止 GnRH 促效剂治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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