Male-to-Female Transgender Fertility Preservation

For trans-female patients, gender-affirming medical and surgical treatments can impact reproductive potential. While these treatments help align one's physical characteristics with gender identity, they may reduce or eliminate the ability to have biological children in the future. Fertility Preservation (FP) offers options for those who wish to maintain the possibility of having genetically related offspring. 

Why Consider Fertility Preservation?

Many transfeminine individuals may desire biological children, but historically, discussions around FP have been lacking in transgender healthcare. The World Professional Association for Transgender Health (WPATH) recommends that all transgender individuals be counseled on their fertility options before initiating hormone therapy or undergoing surgery. Despite this recommendation, many trans individuals report not receiving adequate counseling on FP.

Fertility Preservation Options

There are several FP methods available for transfemale individuals, depending on the stage of transition:

Before Initiating Gender-Affirming Hormone Therapy (GAHT)

• Sperm cryopreservation: the most established method involves collecting and freezing sperm for future use with Assisted Reproductive Technologies (ART), such as IntraUterine Insemination (IUI) or In Vitro Fertilization (IVF)
• Sperm extraction procedures: if ejaculation is distressing, sperm can be retrieved through alternative methods like vibratory stimulation, electroejaculation, or microsurgical sperm extraction

After Starting Gender-Affirming Hormone Therapy (GAHT)

• Sperm banking with hormone cessation: some studies suggest that stopping GAHT for a period (approximately three–six months) can allow partial recovery of sperm production; however, results vary, and not all individuals regain fertility - semen analysis with cryopreservation is the preferred initial approach; if no sperm is found in the semen or ejaculation is not possible, microsurgical TEsticular Sperm Extraction (TESE) may be considered as an alternative

Would You Like an Appointment?

To request an appointment or learn more about our program, please call our office at (646) 962-4811. Our phone staff is available Monday through Friday, 9 a.m. to 5 p.m. (EST).

Meet our expert provider who specializes in male-to-female transgender fertility preservation: