Fertility Preservation Outcomes in Adolescent and Young Adult Feminizing Transgender Patients
| Autor: | Marie N. Menke, Emily P. Barnard, Selma F. Witchel, Cherie Priya Dhar, Kyle E. Orwig, Stephanie S. Rothenberg, Gerald T. Montano, Hanna Valli-Pulaski |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Gender dysphoria
Counseling Male Pediatrics medicine.medical_specialty Adolescent Semen analysis Spironolactone Semen collection Gonadotropin-Releasing Hormone 03 medical and health sciences Young Adult 0302 clinical medicine Semen 030225 pediatrics Transgender Medicine Humans Fertility preservation Young adult Gender Dysphoria Retrospective Studies Azoospermia Cryopreservation medicine.diagnostic_test Estradiol business.industry Fertility Preservation Estrogens medicine.disease Semen cryopreservation Pediatrics Perinatology and Child Health Female business |
| Zdroj: | Pediatrics. 144(3) |
| ISSN: | 1098-4275 |
| Popis: | BACKGROUND: Fertility preservation enables patients undergoing gonadotoxic therapies to retain the potential for biological children and now has broader implications in the care of transgender individuals. Multiple medical societies recommend counseling on fertility preservation before initiating therapy for gender dysphoria; however, outcome data pre- and posttreatment are limited in feminizing transgender adolescents and young adults. METHODS: The University of Pittsburgh Institutional Research Board approved this study. Data were collected retrospectively on transgender patients seeking fertility preservation between 2015 and 2018, including age at initial consultation and semen analysis parameters. RESULTS: Eleven feminizing transgender patients accepted a referral for fertility preservation during this time; consultation occurred at median age 19 (range 16–24 years). Ten patients attempted and completed at least 1 semen collection. Eight patients cryopreserved semen before initiating treatment. Of those patients, all exhibited low morphology with otherwise normal median semen analysis parameters. In 1 patient who discontinued leuprolide acetate to attempt fertility preservation, transient azoospermia of 5 months’ duration was demonstrated with subsequent recovery of spermatogenesis. In a patient who had previously been treated with spironolactone and estradiol, semen analysis revealed persistent azoospermia for the 4 months leading up to orchiectomy after discontinuation of both medications. CONCLUSIONS: Semen cryopreservation is a viable method of fertility preservation in adolescent and young adult transgender individuals and can be considered in patients who have already initiated therapy for gender dysphoria. Further research is needed to determine the optimal length of time these therapies should be discontinued to facilitate successful semen cryopreservation. |
| Databáze: | OpenAIRE |
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