Fertility treatment and preservation in transgender men and women

The scientific and medical world, as well as society at large, may need more time to accept and internalize the concept of transsexual reproduction. The goal of this chapter is to emphasize that trans men and women should be offered various options of assisted reproductive technology (ART) treatment, equal to the fertility preservation treatment that cancer patients receive. Specifically, transgender women (male-to-female transsexual patients), prior to hormonal therapy, should be offered sperm cryopreservation or, in adolescents, testicular biopsy with testicular tissue cryopreservation for future use: for transplantation, or the use of spermatogonial stem cells for in vitro maturation into spermatozoa. Trans men (female-to-male transsexual patients) should be offered cryopreservation of oocytes, or of ovarian tissue, before and during the androgenic therapy or oophorectomy. Data accumulated on gay and lesbian couples suggest that with the new technologies and treatment options, transgender people too can benefit from equal opportunities to produce children, as do other gender-nonconforming people.