Fertility

[MollyPants]

Hiya

My partner has been really supportive of me since I came out to her. It's still early days though and we're working out how (and probably if :/) things will work. I wondered how people have managed fertility? Thank you

Molly


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[KathyLauren]

Hi, Molly!

Welcome to Susan's.

I'm not sure I can help you with your question.  I have no intention of having offspring at my age (62), so lack of fertility is a good thing for me.


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[MollyPants]

 Thank you KathyLauren


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[Kendra]

Hi Molly!

When you get a chance it would be great if you can introduce yourself in the Introductions Forum.  In the meantime, based on what I am reading here I am going to assume you are MtF (please correct me if I'm wrong). 

I am MtF and I just turned 54.  I know that's approaching upper years to be having childern but it's possible I might decide to in the future.  So I went to a local fertility clinic (I live near Seattle) and had my sperm cyrogenically frozen. 

I initially tried to do this at a different Seattle-area fertility clinic recommended by my gender therapist, and the other clinic told me they require a letter from my therapist or doctor.  Frankly I was shocked and offended.  I asked them, as an adult do they really think I need to obtain permission to masturbate in a cup?  I took my business elsewhere.

At the fertility clinic I went to I gained some interesting information.  The doctor I met with explained male sperm is produced roughly 72 days in advance - there is a brief window after starting HRT where it's possible to preserve sperm that was produced before the start of HRT.  From a medical standpoint the age of a person producing sperm is less critical than age of a person producing the egg.  They examined my sperm in their lab and found it was just fine from the standpoint of freezing and potential use in the future. 

A more practical issue is many MtF on HRT have found they have increasing difficulty in producing the stuff you would need to get frozen.  After a longer amount of time on MtF HRT sperm count drops sharply and becomes unusable.  My endocrinologist also asked about this at our first meeting, her advice is freeze the stuff soon as possible if there is any possibility of wanting this in the future. 

[sarah1972]

Hi Molly -

I am in the same boat as Kendra (or the same freezer). Mine where actually frozen before I realized being transgender for a different reason but I just kept it going. There are some reports that sperm production starts again once you stop HRT and some time however there is no guarantee. Unfortunately if you want to keep you choices open, freezing is the only safe way.

Oh - and it really works: my frozen sperm has already been the source of endless joy (and a bunch of sleepless nights)

And just in case Kendra and I assumed wrong: You can also freeze eggs. Works the same way.

I would highly recommend shopping around for places to cryogenically freeze sperm / eggs. They do charge annual storage fees and at least my place is not really cheap.

Good luck on your journey!

Hugs - Sarah

[MollyPants]

Hi Kendra, Sarah

Thank you for the replies. This is really helpful! I'd read up on freezing sperm but it's hard to know how what the clinics say will play out in real life. This is very reassuring.

Thank you
Molly x

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[Ashley3]

... I wondered how people have managed fertility? Thank you ...

I specifically cryopreserved before HRT.

My understanding is that after HRT there are some issues which can arise even if the donor sperm seems okay. I don't have the details but the impression I'm under is that cryopreservation before HRT is most desired, and after HRT is to be avoided. Maybe someone else here can say. A decent fertility lab should know the deal on this. But from my layperson's perspective it makes sense... you're trying to store something optimally produced by a fully functioning genetic male body. Transitioning steps such as HRT involve affecting the genetic male body so that it hormonally matches that of a genetic (cis) woman's body which makes that body incompatible with healthy sperm production.

That's sort of part one of what I remember... then...

I also vaguely recall there being studies where a genetic male body having started female hormone treatments (HRT) who then decides to stop HRT has possibly permanently affected sperm production henceforth, even after HRT stops. I believe the studies that point to this are inconclusive but I recall it was like enough data to be cautious about it. I think it's likely that if you've been on HRT for only one week and then stop HRT that your sperm production may still be fine...  but I recall there were hints in some studies (or perhaps GP advice based on GP having read studies) that there's potential risks that increase as you continue on HRT such that it was expressed to me that I should simply assume effectively no fertility after starting HRT even if I stop. For this reason, I not only made sure to cryopreserve before HRT, but I also made sure to start HRT only after I was 100% certain both cryopreservation had been successful and that I was ready to rely upon cryopreservation as my sole source of personal fertility (that I was ready to understand I'd no longer rely on my body's functioning in that regard).

[MollyPants]

I specifically cryopreserved before HRT.

My understanding is that after HRT there are some issues which can arise even if the donor sperm seems okay. I don't have the details but the impression I'm under is that cryopreservation before HRT is most desired, and after HRT is to be avoided. Maybe someone else here can say. A decent fertility lab should know the deal on this. But from my layperson's perspective it makes sense... you're trying to store something optimally produced by a fully functioning genetic male body. Transitioning steps such as HRT involve affecting the genetic male body so that it hormonally matches that of a genetic (cis) woman's body which makes that body incompatible with healthy sperm production.

That's sort of part one of what I remember... then...

I also vaguely recall there being studies where a genetic male body having started female hormone treatments (HRT) who then decides to stop HRT has possibly permanently affected sperm production henceforth, even after HRT stops. I believe the studies that point to this are inconclusive but I recall it was like enough data to be cautious about it. I think it's likely that if you've been on HRT for only one week and then stop HRT that your sperm production may still be fine...  but I recall there were hints in some studies (or perhaps GP advice based on GP having read studies) that there's potential risks that increase as you continue on HRT such that it was expressed to me that I should simply assume effectively no fertility after starting HRT even if I stop. For this reason, I not only made sure to cryopreserve before HRT, but I also made sure to start HRT only after I was 100% certain both cryopreservation had been successful and that I was ready to rely upon cryopreservation as my sole source of personal fertility (that I was ready to understand I'd no longer rely on my body's functioning in that regard).

Hi Ashley3

Thank you for this, it makes sense that sperm would stop being made. I'll have to find somewhere that can freeze and store them. It's a relief that there isn't a time limit on them.

Molly x

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[Ashley3]

...  It's a relief that there isn't a time limit on them. ...

When you say "that there isn't a time limit on them" ... do you mean on how long sperm can be stored as part of cryopreservation? If so, I'm under the impression there is a very real limit... I've heard about 10 years from the point where the donor sperm are collected. So I'm under the impression that I've got a very real "biological clock" ticking... so to speak. If you weren't referring to the life span of the donor sperm then forgive me on that. Of course, technologies can change/improve so I'd personally recommend to always check with a reputable fertility clinic. 

[Kendra]

I have heard of cases where cryogenic storage was used successfully quite a bit further out than a decade - I don't know the details so I might be wrong.  But the consistent advice I have received from professionals (my endocrinologist, and a doctor at the fertility clinic I used) is get it frozen before starting HRT, and don't assume an interruption in HRT will cause production to re-start.  The doctor at my fertility clinic said a few days after initial start of HRT might be ok, but in his view that is the permanent end to the safe window of opportunity.