Mp42-14 Extended Sperm Search and Microfreeze for Fertility Preservation After Long-Term Hormone Therapy in Transgender Women

You have accessJournal of UrologyInfertility: Therapy (MP42)1 May 2024MP42-14 EXTENDED SPERM SEARCH AND MICROFREEZE FOR FERTILITY PRESERVATION AFTER LONG-TERM HORMONE THERAPY IN TRANSGENDER WOMEN Nathalie Eid, Aderonke Badewa, Tristan Charran, Chaya Rothschild, Michael Werner, and Bobby Najari Nathalie EidNathalie Eid , Aderonke BadewaAderonke Badewa , Tristan CharranTristan Charran , Chaya RothschildChaya Rothschild , Michael WernerMichael Werner , and Bobby NajariBobby Najari View All Author Informationhttps://doi.org/10.1097/01.JU.0001008688.39367.31.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Many transgender women (TW) seek fertility preservation (FP) after starting hormone therapy. However, gender-affirming hormone therapy (GAHT), particularly anti-androgens and estrogens, have been shown to impair sperm production and semen quality. Thus, current traditional fertility preservation methods for TW, including ejaculated sperm cryopreservation and testicular sperm extraction (TESE), are often unsuccessful. This case series seeks to study Extended Sperm Search and Microfreeze (ESSM), a novel and efficient technique that may provide hope to transgender women on longstanding GAHT with previous unsuccessful FP attempts. METHODS: Three TW presented for fertility preservation prior to gender affirming vaginoplasty with simultaneous orchiectomy. After conventional semen analyses demonstrated complete azoospermia after several attempts, all three patients were referred for ESSM, utilizing individual sperm vitrification of a semen sample 24 hours before surgery. Characteristics and ESSM results of the three patients were compared. RESULTS: Patient 1 was a 40 year old TW who spent 20 years on GAHT before discontinuing estrogen therapy for 11 months. Patient 2 was a 27 year old TW on GAHT for over 6 years before decreasing GAHT dosage for 4 months. Patient 3 was a 39 year old TW with 21 year of GAHT usage before discontinuing 1 year and starting Clomiphene 10 months prior to the ESSM. Two out of three patients successfully retrieved and cryopreserved sperm after extended sperm search and microfreeze procedure (Table 1). Notably, both patients 2 and 3 also underwent an unsuccessful TESE. However, patient 2 had a successful ESSM whereas patient 3 did not. CONCLUSIONS: The findings from this case study underscore the potential use for ESSM as a tool for fertility preservation in transgender women who have undergone multiple years of hormonal therapy and have unsuccessful semen analyses and testicular extractions. Future research involving larger cohorts and follow up for the success of conception using the recovered sperm in in-vitro fertilization and intracytoplasmic sperm injections is necessary to evaluate the fertility viability of the sperm after thawing. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e689 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Nathalie Eid More articles by this author Aderonke Badewa More articles by this author Tristan Charran More articles by this author Chaya Rothschild More articles by this author Michael Werner More articles by this author Bobby Najari More articles by this author Expand All Advertisement PDF downloadLoading ...