FTM - retrieving eggs without freezing?

[Flambeau]

Hi, all. I'm a trans man whose been on T for almost 10 years now, and while I wish I had my eggs frozen before starting T, what's done is done, so I'm wondering about other fertility options.

Stopping T for months and then going through the IVF/egg freezing process sounds really scary to me. But I definitely would like to have biological kids someday if I'm able.

So let's say I get married to a cis man and a couple years down the road, we're ready to have kids. Let's say we already find a surrogate. Would I be able to stop T (for however many months) and just have my eggs retrieved without going through IVF?

It still scares me to think of stopping T for months (for my mental health), but it would at least be less daunting if I didn't have to inject myself with hormones and such.

Thanks for any advice/info!

[Lori Dee]

@Flambeau

Hello Flambeau,

I'm Lori Dee. Welcome to Susan's Place!

Thank you for becoming our newest member.

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You ask some very valid questions! However, none of us here are medical professionals so it might be better to talk to your doctor about this. The advancements in medical technology make many procedures less scary and more routine. Your doctor can best advise was is or is not possible.

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@Sarah B
@Northern Star Girl

[Sarah B]

Hello Flambeau

My name is Sarah B and I would also like to formally, Welcome you to Susan's Place!

I see that Lori has also welcomed you as well.  I'm sorry I did not welcome you sooner, but your introduction got me thinking.  Hence the delay.

Thank you for sharing your thoughts. I understand that navigating fertility options after nearly 10 years on testosterone is quite daunting and it is valid wish that you had frozen your eggs earlier.  Stopping T for an extended period and considering IVF can feel overwhelming, especially regarding your mental health.

So it may be beneficial to seek counselling regarding this issue, especially if it intersects with your experiences of gender dysphoria.  It's great that you're thinking about having biological kids and seeking ways to achieve this.

It is important to explore all options that fit your needs. Connecting with specialists familiar with your situation could provide clarity and support. Your journey matters and I hope you find the answers you are looking for as you are in uncharted waters and as Lori basically said, you need to consult with your primary physicians, doctors, endocrinologists and obstetricians on this.

From what I have gathered, Testosterone therapy can suppress ovarian function and disrupt menstrual cycles, but many individuals regain ovarian function after discontinuing treatment. Recovery timelines vary, some may ovulate regularly within months, while others it may take longer.

However, before one tries to conceive, it would be prudent to have a fertility evaluation, including hormone testing and possibly an ultrasound.  In some cases as you have mentioned, assisted reproductive technologies (ART) like in vitro fertilization (IVF) may be helpful for you, particularly if there are concerns with ovulation or egg quality.

Some of the literature I have come across in regards to your issue are:

• Gonzalez, J. L., et al. (2017). "The Effects of Testosterone Therapy on Female Fertility: A Review." Journal of Sexual Medicine, 14(1), 25-32.  This paper reviews the impact of testosterone therapy on female reproductive health and the potential for fertility restoration after discontinuation.
• Gooren, L. J., & Giltay, E. J. (2008). "Long-term Effects of Cross-Sex Hormonal Treatment on Sexual Function in Transsexuals." The Journal of Sexual Medicine, 5(2), 264-270.  Discusses the effects of hormonal treatments on sexual and reproductive health, emphasizing the reversibility of certain effects.
• Schmidt, P. J., et al. (2006). "Effects of Testosterone Replacement Therapy on Ovulation and Ovarian Function." Journal of Clinical Endocrinology & Metabolism, 91(4), 1210-1216.  Examines the effects of testosterone on ovarian function and fertility in women.
• Rothblatt, M. (2016). "Transgender Health: A Review of the Medical Literature." Journal of the Endocrine Society, 1(10), 1228-1245.  This review highlights the medical implications of hormone therapy and considerations for fertility in transgender individuals.
• Meyer, W. J., et al. (2013). "Infertility in Women with Congenital Adrenal Hyperplasia Treated with Glucocorticoids: A Study of Long-Term Outcomes." Fertility and Sterility, 100(2), 365-371.  Although focused on a specific condition, it provides insights into the impact of long-term steroid use on female fertility

Thank you for providing such a thought provoking subject as I allude to below, I have certainly learnt something new.

Once you feel comfortable here, it would be appreciated if you add a little bit more about yourself in the other forums and threads.  I would appreciate it very much as, I'm always interested in learning something new about new members

In addition members of Susan's will more than likely will discuss problems or issues that are similar to yours as most have experienced these issues as well.

Take care and all the best for the future.

Once again, Welcome to Susan's Place!

Best Wishes Always
Sarah B
Global Moderator
@Lori Dee
@Northern Star Girl
@ Flamebeau

[TanyaG]

So let's say I get married to a cis man and a couple years down the road, we're ready to have kids. Let's say we already find a surrogate. Would I be able to stop T (for however many months) and just have my eggs retrieved without going through IVF?

Welcome Flambeau.

Sarah B and Lori have posted some useful advice, but I've also spent some time reading around this subject. It wasn't my specialty, but the short answer is there isn't much research about the outcomes of egg retrieval in your situation.

There is plenty of research about fertility in cis women who have been on low doses of T but very little other than that. The most comprensive study I can find is this:

Chan-Sui, Ruth, Robin Kruger, Evelyn Cho, Vasantha Padmanabhan, Molly Moravek, and Ariella Shikanov. "Effects of Transmasculine Gender-Affirming Hormone Therapy on Future Reproductive Capacity: Clinical Data, Animal Models." Reproduction (Cambridge, England) 168 (2024).

I find DOIs easier and so you can find the full text of this paper using 10.1530/REP-24-0163. Many browsers will translate the DOI to a link, but if not, just put https://doi.org/ before it and it will take you to the paper.

The key sentence for you is : 'At this time, individuals are typically recommended to undergo fertility preservation or stop treatment, associating T-therapy with a loss of fertility; however, there is an absence of consistent information regarding the true fertility potential for transgender and gender-diverse adults and adolescents.'

Addressing your question, at least some specialists are recommending stopping T and as you will doubtless know, an ovarian stimulation cycle is around two weeks of daily treatment on top of that. The paper says the reason for this is, 'an assumption of ameliorating teratogenic outcomes in offspring associated with prolonged T-treatment.'

Note the word 'assumption'. What the authors are saying is we don't know what the effects of prologed T are in this case.

The other relevant quote from the paper is: 'Although many seek parenthood, particularly as a gestational parent or through surrogacy, the current standard guidance of fertility counseling for individuals on testosterone (T) lacks clarity.'

The good news is that you don't have to consider this now and the hope is that over the next few years, the research needed will be done. Two case studies 'did not involve a cessation of T-therapy prior to oocyte retrieval, suggesting that pausing T-therapy may not be necessary for trans men who want to use their oocytes for surrogate pregnancies.'

For you, this is a kind of watch this space situation.

[Flambeau]

Thank you for all the replies so far. I do plan to seek out a specialist but wanted to hear from others, in case any of you have actually gone through it and have information from that side. I appreciate the research shared so far. I hope more research is done in the near future, but I'm already 32, so I don't have all the time in the world, unfortunately! I'm not super panicked yet, but I feel like the sooner, the better. Ideally, I don't really want to push it past 36.