Skip to main content
Erschienen in: Reviews in Endocrine and Metabolic Disorders 3/2018

15.09.2018

Fertility preservation options in transgender people: A review

verfasst von: Natnita Mattawanon, Jessica B. Spencer, David A. Schirmer III, Vin Tangpricha

Erschienen in: Reviews in Endocrine and Metabolic Disorders | Ausgabe 3/2018

Einloggen, um Zugang zu erhalten

Abstract

Gender affirming procedures adversely affect the reproductive potential of transgender people. Thus, fertility preservation options should be discussed with all transpeople before medical and surgical transition. In transwomen, semen cryopreservation is typically straightforward and widely available at fertility centers. The optimal number of vials frozen depends on their reproductive goals and treatment options, therefore a consultation with a fertility specialist is optimal. Experimental techniques including spermatogonium stem cells (SSC) and testicular tissue preservation are technologies currently under development in prepubertal individuals but are not yet clinically available. In transmen, embryo and/or oocyte cryopreservation is currently the best option for fertility preservation. Embryo cryopreservation requires fertilization of the transman’s oocytes with a donor or partner’s sperm prior to cryopreservation, but this limits his future options for fertilizing the eggs with another partner or donor. Oocyte cryopreservation offers transmen the opportunity to preserve their fertility without committing to a male partner or sperm donor at the time of cryopreservation. Both techniques however require at least a two-week treatment course, egg retrieval under sedation and considerable cost. Ovarian tissue cryopreservation is a promising experimental method that may be performed at the same time as gender affirming surgery but is offered in only a limited amount of centers worldwide. In select places, this method may be considered for prepubertal children, adolescents, and adults when ovarian stimulation is not possible. Novel methods such as in-vitro activation of primordial follicles, in vitro maturation of immature oocytes and artificial gametes are under development and may hold promise for the future.
Literatur
3.
Zurück zum Zitat WPATH. Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People Version 7. 2011. WPATH. Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People Version 7. 2011.
7.
Zurück zum Zitat De Sutter P, Kira K, Verschoor A, Hotimsky A. The Desire to have Children and the Preservation of Fertility in Transsexual Women: A Survey. Int J Transgend. 2002;6(3). De Sutter P, Kira K, Verschoor A, Hotimsky A. The Desire to have Children and the Preservation of Fertility in Transsexual Women: A Survey. Int J Transgend. 2002;6(3).
18.
Zurück zum Zitat Nieschlag E, Kamischke A, Behre H. Hormonal male contraception: the essential role of testosterone. In: Testosterone: action, deficiency, substitution. 3rd ed. Cambridge: Cambridge University Press; 2004. p. 685–714.CrossRef Nieschlag E, Kamischke A, Behre H. Hormonal male contraception: the essential role of testosterone. In: Testosterone: action, deficiency, substitution. 3rd ed. Cambridge: Cambridge University Press; 2004. p. 685–714.CrossRef
19.
Zurück zum Zitat Fredricsson B, Carlstrom K. Effects of low doses of cyproterone acetate on sperm morphology and some other parameters of reproduction in normal men. Andrologia. 1981;13(4):369–75.CrossRef Fredricsson B, Carlstrom K. Effects of low doses of cyproterone acetate on sperm morphology and some other parameters of reproduction in normal men. Andrologia. 1981;13(4):369–75.CrossRef
20.
Zurück zum Zitat Fogh M, Corker CS, Hunter WM, McLean H, Philip J, Schou G, et al. The effects of low doses of cyproterone acetate on some functions of the reproductive system in normal men. Acta Endocrinol. 1979;91(3):545–52.CrossRef Fogh M, Corker CS, Hunter WM, McLean H, Philip J, Schou G, et al. The effects of low doses of cyproterone acetate on some functions of the reproductive system in normal men. Acta Endocrinol. 1979;91(3):545–52.CrossRef
21.
Zurück zum Zitat Wang C, Yeung KK. Use of low-dosage oral cyproterone acetate as a male contraceptive. Contraception. 1980;21(3):245–72.CrossRef Wang C, Yeung KK. Use of low-dosage oral cyproterone acetate as a male contraceptive. Contraception. 1980;21(3):245–72.CrossRef
22.
Zurück zum Zitat Meriggiola MC, Bremner WJ, Costantino A, Di Cintio G, Flamigni C. Low dose of cyproterone acetate and testosterone enanthate for contraception in men. Hum Reprod. 1998;13(5):1225–9.CrossRef Meriggiola MC, Bremner WJ, Costantino A, Di Cintio G, Flamigni C. Low dose of cyproterone acetate and testosterone enanthate for contraception in men. Hum Reprod. 1998;13(5):1225–9.CrossRef
24.
Zurück zum Zitat Steelman SL, Brooks JR, Morgan ER, Patanelli DJ. Anti-androgenic activity of spironolactone. Steroids. 1969;14(4):449–50.CrossRef Steelman SL, Brooks JR, Morgan ER, Patanelli DJ. Anti-androgenic activity of spironolactone. Steroids. 1969;14(4):449–50.CrossRef
26.
Zurück zum Zitat Mokhtar M, Shariatie M, Tadayon N. The effect of spironolactone on concentration of LH, FSH, testosterone Di-hydrotestosterone and spermatogenesis in rats. J Ardabil Univ Med Sci. 2007;7(1):62–8. Mokhtar M, Shariatie M, Tadayon N. The effect of spironolactone on concentration of LH, FSH, testosterone Di-hydrotestosterone and spermatogenesis in rats. J Ardabil Univ Med Sci. 2007;7(1):62–8.
29.
Zurück zum Zitat Lunglmayr G, Girsch E, Meixner EM, Viehberger G, Bieglmayer C. Effects of long term GnRH analogue treatment on hormone levels and spermatogenesis in patients with carcinoma of the prostate. Urol Res. 1988;16(4):315–9.CrossRef Lunglmayr G, Girsch E, Meixner EM, Viehberger G, Bieglmayer C. Effects of long term GnRH analogue treatment on hormone levels and spermatogenesis in patients with carcinoma of the prostate. Urol Res. 1988;16(4):315–9.CrossRef
30.
Zurück zum Zitat Labrie F, Cusan L, Seguin C, Belanger A, Pelletier G, Reeves J, et al. Antifertility effects of LHRH agonists in the male rat and inhibition of testicular steroidogenesis in man. Int J Fertil. 1980;25(3):157–70.PubMed Labrie F, Cusan L, Seguin C, Belanger A, Pelletier G, Reeves J, et al. Antifertility effects of LHRH agonists in the male rat and inhibition of testicular steroidogenesis in man. Int J Fertil. 1980;25(3):157–70.PubMed
32.
Zurück zum Zitat Linde R, Doelle GC, Alexander N, Kirchner F, Vale W, Rivier J, et al. Reversible inhibition of testicular steroidogenesis and spermatogenesis by a potent gonadotropin-releasing hormone agonist in normal men: an approach toward the development of a male contraceptive. N Engl J Med. 1981;305(12):663–7. https://doi.org/10.1056/NEJM198109173051203.CrossRefPubMed Linde R, Doelle GC, Alexander N, Kirchner F, Vale W, Rivier J, et al. Reversible inhibition of testicular steroidogenesis and spermatogenesis by a potent gonadotropin-releasing hormone agonist in normal men: an approach toward the development of a male contraceptive. N Engl J Med. 1981;305(12):663–7. https://​doi.​org/​10.​1056/​NEJM198109173051​203.CrossRefPubMed
33.
Zurück zum Zitat Kuber W, Viehberger G, Zeillinger R, Spona J. Effects of the duration of therapy with the LHRH agonist D-ser (BUT)6 Azgly10-LHRH (ICI 118-630) on the steroid hormone content and the morphology of human testicular tissue in the treatment of patients with advanced prostate cancer. Urol Res. 1991;19(1):19–24.CrossRef Kuber W, Viehberger G, Zeillinger R, Spona J. Effects of the duration of therapy with the LHRH agonist D-ser (BUT)6 Azgly10-LHRH (ICI 118-630) on the steroid hormone content and the morphology of human testicular tissue in the treatment of patients with advanced prostate cancer. Urol Res. 1991;19(1):19–24.CrossRef
37.
Zurück zum Zitat Thiagaraj D, Gunasegaram R, Loganath A, Peh KL, Kottegoda SR, Ratnam SS. Histopathology of the testes from male transsexuals on oestrogen therapy. Ann Acad Med Singap. 1987;16(2):347–8.PubMed Thiagaraj D, Gunasegaram R, Loganath A, Peh KL, Kottegoda SR, Ratnam SS. Histopathology of the testes from male transsexuals on oestrogen therapy. Ann Acad Med Singap. 1987;16(2):347–8.PubMed
38.
Zurück zum Zitat Schulze C. Response of the human testis to long-term estrogen treatment: morphology of Sertoli cells, Leydig cells and spermatogonial stem cells. Cell Tissue Res. 1988;251(1):31–43.CrossRef Schulze C. Response of the human testis to long-term estrogen treatment: morphology of Sertoli cells, Leydig cells and spermatogonial stem cells. Cell Tissue Res. 1988;251(1):31–43.CrossRef
45.
Zurück zum Zitat Meseguer M, Garrido N, Remohi J, Pellicer A, Simon C, Martinez-Jabaloyas JM, et al. Testicular sperm extraction (TESE) and ICSI in patients with permanent azoospermia after chemotherapy. Hum Reprod. 2003;18(6):1281–5.CrossRef Meseguer M, Garrido N, Remohi J, Pellicer A, Simon C, Martinez-Jabaloyas JM, et al. Testicular sperm extraction (TESE) and ICSI in patients with permanent azoospermia after chemotherapy. Hum Reprod. 2003;18(6):1281–5.CrossRef
50.
Zurück zum Zitat Guizar-Vazquez JJ, Rosales-Lopez A, Ortiz-Jalomo R, Nava-Delgado SE, Salamanca-Gomez F. Age of onset of spermaturia (spermache) in 669 Mexican children and its relation to secondary sexual characteristics and height. Bol Med Hosp Infant Mex. 1992;49(1):12–7.PubMed Guizar-Vazquez JJ, Rosales-Lopez A, Ortiz-Jalomo R, Nava-Delgado SE, Salamanca-Gomez F. Age of onset of spermaturia (spermache) in 669 Mexican children and its relation to secondary sexual characteristics and height. Bol Med Hosp Infant Mex. 1992;49(1):12–7.PubMed
54.
Zurück zum Zitat Bahadur G, Ling KL, Hart R, Ralph D, Wafa R, Ashraf A, et al. Semen quality and cryopreservation in adolescent cancer patients. Hum Reprod. 2002;17(12):3157–61.CrossRef Bahadur G, Ling KL, Hart R, Ralph D, Wafa R, Ashraf A, et al. Semen quality and cryopreservation in adolescent cancer patients. Hum Reprod. 2002;17(12):3157–61.CrossRef
59.
Zurück zum Zitat Bertelloni S, Baroncelli GI, Ferdeghini M, Menchini-Fabris F, Saggese G. Final height, gonadal function and bone mineral density of adolescent males with central precocious puberty after therapy with gonadotropin-releasing hormone analogues. Eur J Pediatr. 2000;159(5):369–74.CrossRef Bertelloni S, Baroncelli GI, Ferdeghini M, Menchini-Fabris F, Saggese G. Final height, gonadal function and bone mineral density of adolescent males with central precocious puberty after therapy with gonadotropin-releasing hormone analogues. Eur J Pediatr. 2000;159(5):369–74.CrossRef
61.
Zurück zum Zitat Tuckerman EM, Okon MA, Li T, Laird SM. Do androgens have a direct effect on endometrial function? An in vitro study. Fertil Steril. 2000;74(4):771–9.CrossRef Tuckerman EM, Okon MA, Li T, Laird SM. Do androgens have a direct effect on endometrial function? An in vitro study. Fertil Steril. 2000;74(4):771–9.CrossRef
63.
Zurück zum Zitat Miller N, Bedard YC, Cooter NB, Shaul DL. Histological changes in the genital tract in transsexual women following androgen therapy. Histopathology. 1986;10(7):661–9.CrossRef Miller N, Bedard YC, Cooter NB, Shaul DL. Histological changes in the genital tract in transsexual women following androgen therapy. Histopathology. 1986;10(7):661–9.CrossRef
65.
Zurück zum Zitat Spinder T, Spijkstra JJ, van den Tweel JG, Burger CW, van Kessel H, Hompes PG, et al. The effects of long term testosterone administration on pulsatile luteinizing hormone secretion and on ovarian histology in eugonadal female to male transsexual subjects. J Clin Endocrinol Metab. 1989;69(1):151–7. https://doi.org/10.1210/jcem-69-1-151.CrossRefPubMed Spinder T, Spijkstra JJ, van den Tweel JG, Burger CW, van Kessel H, Hompes PG, et al. The effects of long term testosterone administration on pulsatile luteinizing hormone secretion and on ovarian histology in eugonadal female to male transsexual subjects. J Clin Endocrinol Metab. 1989;69(1):151–7. https://​doi.​org/​10.​1210/​jcem-69-1-151.CrossRefPubMed
66.
Zurück zum Zitat Amirikia H, Savoy-Moore RT, Sundareson AS, Moghissi KS. The effects of long-term androgen treatment on the ovary. Fertil Steril. 1986;45(2):202–8.CrossRef Amirikia H, Savoy-Moore RT, Sundareson AS, Moghissi KS. The effects of long-term androgen treatment on the ovary. Fertil Steril. 1986;45(2):202–8.CrossRef
67.
68.
Zurück zum Zitat Caanen MR, Schouten NE, Kuijper EAM, van Rijswijk J, van den Berg MH, van Dulmen-den Broeder E, et al. Effects of long-term exogenous testosterone administration on ovarian morphology, determined by transvaginal (3D) ultrasound in female-to-male transsexuals. Hum Reprod. 2017;32(7):1457–64. https://doi.org/10.1093/humrep/dex098.CrossRefPubMed Caanen MR, Schouten NE, Kuijper EAM, van Rijswijk J, van den Berg MH, van Dulmen-den Broeder E, et al. Effects of long-term exogenous testosterone administration on ovarian morphology, determined by transvaginal (3D) ultrasound in female-to-male transsexuals. Hum Reprod. 2017;32(7):1457–64. https://​doi.​org/​10.​1093/​humrep/​dex098.CrossRefPubMed
69.
Zurück zum Zitat Van Den Broecke R, Van Der Elst J, Liu J, Hovatta O, Dhont M. The female-to-male transsexual patient: a source of human ovarian cortical tissue for experimental use. Hum Reprod. 2001;16(1):145–7.CrossRef Van Den Broecke R, Van Der Elst J, Liu J, Hovatta O, Dhont M. The female-to-male transsexual patient: a source of human ovarian cortical tissue for experimental use. Hum Reprod. 2001;16(1):145–7.CrossRef
88.
Zurück zum Zitat Wittmaack FM, Kreger DO, Blasco L, Tureck RW, Mastroianni L Jr, Lessey BA. Effect of follicular size on oocyte retrieval, fertilization, cleavage, and embryo quality in in vitro fertilization cycles: a 6-year data collection. Fertil Steril. 1994;62(6):1205–10.CrossRef Wittmaack FM, Kreger DO, Blasco L, Tureck RW, Mastroianni L Jr, Lessey BA. Effect of follicular size on oocyte retrieval, fertilization, cleavage, and embryo quality in in vitro fertilization cycles: a 6-year data collection. Fertil Steril. 1994;62(6):1205–10.CrossRef
95.
Zurück zum Zitat Schmidt KL, Ernst E, Byskov AG, Nyboe Andersen A, Yding AC. Survival of primordial follicles following prolonged transportation of ovarian tissue prior to cryopreservation. Hum Reprod. 2003;18(12):2654–9.CrossRef Schmidt KL, Ernst E, Byskov AG, Nyboe Andersen A, Yding AC. Survival of primordial follicles following prolonged transportation of ovarian tissue prior to cryopreservation. Hum Reprod. 2003;18(12):2654–9.CrossRef
97.
Zurück zum Zitat Ting AY, Mullen SF, Zelinski MB. Vitrification of ovarian tissue for fertility preservation. In: Woodruff TK, Gosiengfiao YC, editors. Pediatric and adolescent Oncofertility: best practices and emerging technologies. Cham: Springer International Publishing; 2017. p. 79–97.CrossRef Ting AY, Mullen SF, Zelinski MB. Vitrification of ovarian tissue for fertility preservation. In: Woodruff TK, Gosiengfiao YC, editors. Pediatric and adolescent Oncofertility: best practices and emerging technologies. Cham: Springer International Publishing; 2017. p. 79–97.CrossRef
103.
Zurück zum Zitat Abir R, Ben-Aharon I, Garor R, Yaniv I, Ash S, Stemmer SM, et al. Cryopreservation of in vitro matured oocytes in addition to ovarian tissue freezing for fertility preservation in paediatric female cancer patients before and after cancer therapy. Hum Reprod. 2016;31(4):750–62. https://doi.org/10.1093/humrep/dew007.CrossRefPubMed Abir R, Ben-Aharon I, Garor R, Yaniv I, Ash S, Stemmer SM, et al. Cryopreservation of in vitro matured oocytes in addition to ovarian tissue freezing for fertility preservation in paediatric female cancer patients before and after cancer therapy. Hum Reprod. 2016;31(4):750–62. https://​doi.​org/​10.​1093/​humrep/​dew007.CrossRefPubMed
104.
Metadaten
Titel
Fertility preservation options in transgender people: A review
verfasst von
Natnita Mattawanon
Jessica B. Spencer
David A. Schirmer III
Vin Tangpricha
Publikationsdatum
15.09.2018
Verlag
Springer US
Erschienen in
Reviews in Endocrine and Metabolic Disorders / Ausgabe 3/2018
Print ISSN: 1389-9155
Elektronische ISSN: 1573-2606
DOI
https://doi.org/10.1007/s11154-018-9462-3

Weitere Artikel der Ausgabe 3/2018

Reviews in Endocrine and Metabolic Disorders 3/2018 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.