Fertility Options for Transgender Persons

Transgender persons inherently possess normal reproductive capacity, however, hormonal and surgical treatments for transgender people potentially impair the ability of these individuals to reproduce. Additionally, transgender people tend to start gender-affirming treatment at a young age, when reproductive wishes are not yet clearly defined nor fulfilled. The most recent Standards of Care of the World Professional Association for Transgender Health recommend to clearly inform patients on their future reproductive options prior to initiation of treatment. Where surgery definitely results in sterility, hormone therapy on the other hand also has an important, but partially reversible impact on fertility. However, thresholds for cross-sex hormone treatment to avoid permanent reproductive impairment have not been established. The current fertility preservation options for transgender men are embryo cryopreservation, oocyte cryopreservation, and ovarian tissue cryopreservation. For transgender women, sperm cryopreservation, surgical sperm extraction, and testicular tissue cryopreservation are possible.