Transgender fertility
New models of family and fertility in transgender people
Motherhood and fatherhood in transgender couples respond to the same reproductive desire as in the rest of people, that is, the desire to form a family.
Transitioning to a different gender is complex and unique to each individual. Transgender people may or may not choose to modify their bodies with surgical or hormone-based treatment options. Unfortunately, both options have a negative effect on fertility.
At Team Cornel, we believe that the medical community has an important role to play in promoting systemic changes that provide equitable and gender-affirming care for transgender people across the entire spectrum of reproductive health.
Fertility planning in transgender youth
As society progresses, new family models are more present, which helps to normalize gender identities.
More and more children and adolescents are aware of the incongruence between their sex and their gender identity, which leads them to seek specialized medical care that includes multidisciplinary treatments focused on the full satisfaction of the young person or adolescent.
All treatments focused on gender transition that are irreversible or partially reversible therapies such as hormone therapy, have an impact on fertility, therefore, the ideal would be to plan fertility before starting any therapy.
At Equipo Cornel we know that fertility planning in trans people goes beyond mere fertility preservation (FP) through egg or sperm freezing. Although the technique and technologies are the same as for other patients, it is necessary to adapt protocols and procedures to minimize anxiety and gender dysphoria.
Types of trans fertility preservation
Transgender Women
- CTT OR CRYOPRESERVATION OF TESTICULAR TISSUE
CTT is an experimental procedure that consists of surgical removal and cryopreservation of testicular tissue.
It is indicated in prepubertal transgender girls as it is the only option for fertility preservation at this stage of development.
- CRYOPRESERVATION OF SPERM SAMPLE
The simplest and most effective method of FP (Fertility Preservation) in trans women from the postpubertal stage onwards.
It consists of freezing a sperm sample.
However, for many trans women, the use of their genitals can generate significant dysphoria. Samples can also be obtained with the help of , sperm aspiration or microsurgical extraction of sperm directly from parts of the testicles or epididymis.
The youngest age for successful sperm collection for fertility preservation in trans people is 11 years old.
TESE (TESTICULAR SPERM EXTRACTION) AND SEMEN CRYOPRESERVATION
This is a testicular biopsy for the recovery of testicular sperm. It consists of a surgical intervention in which several samples of testicular tissue are extracted in order to obtain optimal sperm.
Transgender Women
CTT OR CRYOPRESERVATION OF TESTICULAR TISSUE
CTT is an experimental procedure that consists of surgical removal and cryopreservation of testicular tissue.
It is indicated in prepubertal transgender girls as it is the only option for fertility preservation at this stage of development.
CRYOPRESERVATION OF SPERM SAMPLE
The simplest and most effective method of FP (Fertility Preservation) in trans women from the postpubertal stage onwards.
It consists of freezing a sperm sample.
However, for many trans women, the use of their genitals can generate significant dysphoria. Samples can also be obtained with the help of , sperm aspiration or microsurgical extraction of sperm directly from parts of the testicles or epididymis.
The youngest age for successful sperm collection for fertility preservation in trans people is 11 years old.
TESE (TESTICULAR SPERM EXTRACTION) AND SEMEN CRYOPRESERVATION
This is a testicular biopsy for the recovery of testicular sperm. It consists of a surgical intervention in which several samples of testicular tissue are extracted in order to obtain optimal sperm.
Transgender Men
- EGG PRESERVATION
Treatments based on the administration of testosterone have a direct impact on the ovarian reserve, although it is reversible, it is always advisable to perform preservation before starting treatment with testosterone.
In order to carry out successful preservation, that is, to obtain a considerable number of eggs in a single treatment, “ovarian stimulation” is necessary.
A medical procedure based on the menstrual cycle in which the patient injects himself daily with a hormonal medication for approximately 10 days. During this phase of ovarian stimulation, gynecological examinations such as transvaginal ultrasound are necessary, which can cause emotional instability and psychological distress. For this reason, at Equipo Cornel we have alternative methods such as ultrasound, transabdominal monitoring or remote ultrasound probe.
If testosterone treatment has begun, discontinuation of this treatment should not exceed the duration of stimulation.
