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Fertility Preservation in Patients with Gender Dysphoria

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Pediatric and Adolescent Oncofertility

Abstract

In 2009 the Endocrine Society’s clinical practice guidelines for care of transsexual persons were published. Since that time society and the medical community have experienced increased acceptance of gender transition in persons with gender dysphoria. The hormone treatment of transindividuals may render them infertile, and thus the guidelines recommend that individuals starting cross-sex hormones be counseled about their effects on fertility and possible fertility preservation options. In this chapter we examine the hormonal treatment for individuals with gender dysphoria, their effects on fertility, as well as fertility preservation options.

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Notes

  1. 1.

    Intentionally grammatically incorrect to avoid using binary gender-based terminology.

Abbreviations

BPA:

Bisphenol A

DES:

Diethylstilbestrol

DHEA:

Didehydroepiandrosterone

GD:

Gender dysphoria

GnRH:

Gonadotropin-releasing hormone

PCBs:

Polychlorinated biphenyls

PCOS:

Polycystic ovarian syndrome

PESA:

Percutaneous sperm aspiration

TESA:

Testicular sperm aspiration

TESE:

Testicular sperm extraction

WPATH:

World Professional Association for Transgender Health

References

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Association; 2013.

    Book  Google Scholar 

  2. Hembree WC, Cohen-Kettenis P, Delemarre-van de Waal HA, Endocrine Society, et al. Endocrine treatment of transsexual persons: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2009;94(9):3132–54.

    Article  CAS  PubMed  Google Scholar 

  3. World Professional Association for Transgender Health (WPATH). Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People. 7th Version. World Professional Association for Transgender Health. 2012.

    Google Scholar 

  4. de Delemarre-Van de Waal HA, Cohen-Kettenis PT. Clinical management of gender identity disorder in adolescents. Eur J Endocrinol. 2006;155 Suppl 1:S131–7.

    Article  CAS  Google Scholar 

  5. Feldman J, Safer J. Hormone therapy in adults: suggested revisions to the sixth version of the standards of care. Int J Transgenderism. 2009;11(3):146–82.

    Article  Google Scholar 

  6. Gooren L. Hormone treatment of the adult transsexual patient. Horm Res. 2005;64 Suppl 2:31–6.

    CAS  PubMed  Google Scholar 

  7. Dumasia K, et al. Effect of estrogen receptor-subtype-specific ligands on fertility in adult male rats. J Endocrinol. 2015;225(3):169–80.

    Article  CAS  PubMed  Google Scholar 

  8. Gill-Sharma MK, et al. Antifertility effects of estradiol in adult male rats. J Endocrinol Invest. 2001;24(8):598–607.

    Article  CAS  PubMed  Google Scholar 

  9. Robaire B, Duron J, Hales BF. Effect of estradiol-filled polydimethylsiloxane subdermal implants in adult male rats on the reproductive system, fertility, and progeny outcome. Biol Reprod. 1987;37(2):327–34.

    Article  CAS  PubMed  Google Scholar 

  10. Sharpe RM, Skakkebaek NE. Are oestrogens involved in falling sperm counts and disorders of the male reproductive tract? Lancet. 1993;341(8857):1392–5.

    Article  CAS  PubMed  Google Scholar 

  11. Fisch H, Hyun G, Golden R. The possible effects of environmental estrogen disrupters on reproductive health. Curr Urol Rep. 2000;1(4):253–61.

    Article  CAS  PubMed  Google Scholar 

  12. Skakkebaek NE, et al. Is human fecundity declining? Int J Androl. 2006;29(1):2–11.

    Article  PubMed  Google Scholar 

  13. Oliva A, Spira A, Multigner L. Contribution of environmental factors to the risk of male infertility. Hum Reprod. 2001;16(8):1768–76.

    Article  CAS  PubMed  Google Scholar 

  14. Rozati R, et al. Role of environmental estrogens in the deterioration of male factor fertility. Fertil Steril. 2002;78(6):1187–94.

    Article  PubMed  Google Scholar 

  15. Du Plessis SS, et al. The effect of obesity on sperm disorders and male infertility. Nat Rev Urol. 2010;7(3):153–61.

    Article  PubMed  Google Scholar 

  16. Pauli EM, et al. Diminished paternity and gonadal function with increasing obesity in men. Fertil Steril. 2008;90(2):346–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Palmer NO, et al. Impact of obesity on male fertility, sperm function and molecular composition. Spermatogenesis. 2012;2(4):253–63.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Pavlovich CP, et al. Evidence of a treatable endocrinopathy in infertile men. J Urol. 2001;165(3):837–41.

    Article  CAS  PubMed  Google Scholar 

  19. Hillier SG, Ross GT. Effects of exogenous testosterone on ovarian weight, follicular morphology and intraovarian progesterone concentration in estrogen-primed hypophysectomized immature female rats. Biol Reprod. 1979;20(2):261–8.

    Article  CAS  PubMed  Google Scholar 

  20. Goerlich VC, Dijkstra C, Groothuis TG. Effects of in vivo testosterone manipulation on ovarian morphology, follicular development, and follicle yolk testosterone in the homing pigeon. J Exp Zool A Ecol Genet Physiol. 2010;313(6):328–38.

    Article  PubMed  Google Scholar 

  21. Velez LM, et al. Effect of hyperandrogenism on ovarian function. Reproduction. 2015;149(6):577–85.

    Article  CAS  PubMed  Google Scholar 

  22. van der Spuy ZM, Dyer SJ. The pathogenesis of infertility and early pregnancy loss in polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol. 2004;18(5):755–71.

    Article  PubMed  Google Scholar 

  23. Dumesic DA, Padmanabhan V, Abbott DH. Polycystic ovary syndrome and oocyte developmental competence. Obstet Gynecol Surv. 2008;63(1):39–48.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Amato MC, et al. Low estradiol-to-testosterone ratio is associated with oligo-anovulatory cycles and atherogenic lipidic pattern in women with polycystic ovary syndrome. Gynecol Endocrinol. 2011;27(8):579–86.

    Article  CAS  PubMed  Google Scholar 

  25. Light AD, et al. Transgender men who experienced pregnancy after female-to-male gender transitioning. Obstet Gynecol. 2014;124(6):1120–7.

    Article  CAS  PubMed  Google Scholar 

  26. Ellis SA, Wojnar DM, Pettinato M. Conception, pregnancy, and birth experiences of male and gender variant gestational parents: it’s how we could have a family. J Midwifery Womens Health. 2015;60(1):62–9.

    Article  PubMed  Google Scholar 

  27. Lawrence AA, Shaffer JD, Snow WR. Healthcare needs of transgendered patients. J Am Med Assoc. 1996;276:874.

    Article  CAS  Google Scholar 

  28. American Academy of Child & Adolescent Psychiatry. Facts for Families: Children with Lesbian, Gay, Bisexual and Transgender Parents. Washington, DC; 2013.

    Google Scholar 

  29. The Ethics Committee of the American Society for Reproductive Medicine. Fertility Preservation and Reproduction in patients facing gonadotoxic therapies. Birmingham, AL; 2013.

    Google Scholar 

  30. Santelli JS, et al. Guidelines for adolescent health research. J Adolesc Health. 2003;33(5):396–409.

    PubMed  Google Scholar 

  31. Fallat ME, Hutter J, American Academy of Pediatrics Committee on Bioethics, American Academy of Pediatrics Section on Hematology/Oncology, American Academy of Pediatrics Section on Surgery. Preservation of fertility in pediatric and adolescent patients with cancer. Pediatrics. 2008;121(5):e1461–9.

    Article  PubMed  Google Scholar 

  32. Bunge RG, Sherman JK. Fertilizing capacity of frozen human spermatozoa. Nature. 1953;172:767–8.

    Article  CAS  PubMed  Google Scholar 

  33. Wang JH, Muller CH, Lin K. Optimizing fertility preservation for pre- and postpubertal males with cancer. Semin Reprod Med. 2013;31:274–85.

    Article  CAS  PubMed  Google Scholar 

  34. Practice Committees of American Society for Reproductive Medicine, Society for Assisted Reproductive Technology. Mature oocyte cryopreservation: a guideline. Fertil Steril. 2013;99:37–43.

    Article  Google Scholar 

  35. Wallace SA, Blough KL, Kondapalli LA. Fertility preservation in the transgender patient: expanding oncofertility care beyond cancer. Gynecol Endocrinol. 2014;30:1–4.

    Article  CAS  Google Scholar 

  36. De Sutter P. Gender reassignment and assisted reproduction: present and future reproductive options for transsexual people. Hum Reprod. 2001;16(4):612–4.

    Article  PubMed  Google Scholar 

  37. Berookhim BM, Mulhall JP. Outcomes of operative sperm retrieval strategies for fertility preservation among males scheduled to undergo cancer treatment. Fertil Steril. 2014;101(3):805–11.

    Article  PubMed  Google Scholar 

  38. Reichman DE, Davis OK, Zaninovic N, Rosenwaks Z, Goldschlag DE. Fertility preservation using controlled ovarian hyperstimulation and oocyte cryopreservation in a premenarcheal female with myelodysplastic syndrome. Fertil Steril. 2012;98(5):1225–8.

    Article  PubMed  Google Scholar 

  39. Loren AW, Mangu PB, Beck LN, Brennan L, Magdalinski AJ, Partridge AH, Quinn G, Wallace WH, Oktay K, American Society of Clinical Oncology. Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013;31(19):2500–10.

    Article  PubMed  Google Scholar 

  40. Schover LR. Patient attitudes toward fertility preservation. Pediatr Blood Cancer. 2009;53(2):281–4.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Women and Infant Services, Department of Surgery, MedStar Washington Hospital Center, Children’s National Medical Center, 110 Irving St NW, Washington, DC, 20010, USA

    Jason Jarin MD & Veronica Gomez-Lobo MD

  2. Division of Urology Chicago, Department of Urology and Center for Healthcare Studies, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University, Feinberg School of Medicine, 225 E. Chicago Ave, Chicago, IL, 60616, USA

    Emilie Johnson MD, MPH

Authors
  1. Jason Jarin MD
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  2. Emilie Johnson MD, MPH
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  3. Veronica Gomez-Lobo MD
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Corresponding author

Correspondence to Jason Jarin MD .

Editor information

Editors and Affiliations

  1. Obstetrics and Gynecology, Northwestern University, Chicago, Illinois, USA

    Teresa K. Woodruff

  2. Northwestern University, Chicago, Illinois, USA

    Yasmin C. Gosiengfiao

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Jarin, J., Johnson, E., Gomez-Lobo, V. (2017). Fertility Preservation in Patients with Gender Dysphoria. In: Woodruff, T., Gosiengfiao, Y. (eds) Pediatric and Adolescent Oncofertility. Springer, Cham. https://doi.org/10.1007/978-3-319-32973-4_12

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  • DOI: https://doi.org/10.1007/978-3-319-32973-4_12

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-32971-0

  • Online ISBN: 978-3-319-32973-4

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