Fertility preservation in the transgender patient: expanding oncofertility care beyond cancer

Abstract

While the field of oncofertility raised awareness about fertility concerns in oncology patients, new applications for fertility preservation are emerging, such as transgender medicine. As transgender medicine evolves, the number of individuals seeking gender reassignment hormone therapy is drastically increasing, generating a population of patients with unmet fertility needs and unknown reproductive potential. We present the first case report of a female-to-male (FtM) transgender patient to undergo oocyte cryopreservation before initiating androgen therapy. Our patient is a 17-year-old FtM transgender person undergoing gender transition throughout adolescence with an endocrinologist. The patient wished to complete androgen therapy before starting his first year of college to avoid gender ambiguity. After extensive consultation and psychological assessment, the patient was considered an appropriate candidate and proceeded with oocyte cryopreservation. He underwent baseline fertility testing followed by successful ovarian stimulation and surgical retrieval. We recommend that a discussion of reproductive health concerns and fertility preservation options be incorporated into the comprehensive care of transgender patients.

Chinese abstract

当为癌症患者保护生殖力的意识逐渐提高的同时，生殖力保护新的应用正在逐渐出现，例如：变性医学。随着变性医学的发展，寻求变性的激素治疗的个体数量也急剧增加，但是这部分人的生育功能没有得到满足，这个人群的生殖潜力未知。我们报道了第一例女性变男性 （female-to-male，FTM）的病例，其在使用雄激素治疗前进行了卵母细胞冷冻保存。本例患者是一名17岁的FTM变性人，其整个青春在内分泌专家的指导下过渡完成。此患者本人希望进入大学之前完成雄激素治疗，以避免性别模糊。经过广泛的咨询和心理评估，此患者被认为是合适的人选，并进行了卵母细胞冷冻保存。经过基础的卵巢刺激生殖功能测试后，进行了取卵手术。本文提出了一个讨论，即生殖健康和生殖力保护的观念和选择可以被纳入到对变性人的全面照顾当中。

• Fertility preservation
• oocyte cryopreservation
• transgender man
• transgender medicine