Egg and Sperm Freezing for Transgender, Gender Nonconforming, and Nonbinary Individuals
Individuals in the transgender, gender nonconforming, and nonbinary (TGNB) community have the option to preserve eggs or sperm for future use. We have the experience to help counsel and guide patients who are interested in learning more about fertility preservation. Here are some frequently asked questions about TGNB fertility preservation.
Before Beginning Fertility Preservation
Does PNWF offer future fertility counseling?
What if I'm already on hormone blockers?
What if I've already started testosterone therapy?
For most patients, we recommend discontinuing testosterone therapy for approximately 1-2 months prior to undergoing egg freezing. However, this is not mandatory, and can be personalized to you.
What if I've already started estrogen therapy?
Your provider will help determine the right plan for you. It may require monthly semen analyses to monitor the return of sperm in the ejaculate. In some cases, surgical sperm extraction may also be an option.
Egg Freezing FAQs
How does egg freezing work?
The process for egg freezing is similar to a traditional IVF cycle. After consultation and testing, it takes approximately 2 weeks. In these two weeks, the patient takes gonadotropins (injectable hormones) to stimulate the recruitment of multiple eggs in the ovaries. When the eggs are ready, they are retrieved in a simple procedure called an egg retrieval, then frozen immediately.
Once you are ready for family building, the eggs are thawed and fertilized with sperm (either from a partner or a sperm donor). The resulting embryo(s) can be genetically tested and then transferred into the uterus of a partner or gestational surrogate.
What is embryo freezing?
What are the limitations of egg freezing?
The success rates and efficiency of the process are tied to how many eggs you can produce, which varies between patients. For example, a patient with low egg numbers may have to do more than one stimulation cycle to freeze an optimal number of eggs.
It is always a good idea to meet with a reproductive endocrinologist and learn more about what egg freezing would look like for you.
I am a transgender patient planning to do egg freezing. What challenges should I expect?
Typical monitoring during the egg freezing process includes transvaginal ultrasounds. If this would be challenging for you, discuss the option of transabdominal ultrasounds with your provider. The medications involved with ovarian stimulation create a brief rise in estrogen during this process, which can affect your mood. You will also have a period 7-10 days after the egg retrieval, which may worsen gender dysphoria.
We strongly recommend that patients have a mental health care provider and consider increasing their counseling frequency during this process.
Sperm Freezing FAQs
How does sperm freezing work?
Sperm is usually collected via masturbation and then frozen for future use. This may require multiple collections to freeze multiple vials, depending on family building goals. We will help guide you through this process.
Frozen sperm can be used for future inseminations or IVF, with a partner’s eggs or donor eggs.
How much sperm should I freeze?
If your semen analysis is normal, you may have enough sperm from one collection for 2-3 intrauterine insemination (IUI) cycles, or several in vitro fertilization (IVF) cycles. If your sperm count or quality is low, sperm preservation for future IVF is still an option, as we only need a few sperm to make IVF possible.
We recommend scheduling an appointment with one of our providers either before or after your first collection to review your goals and determine how many collections to do.
If I want to freeze sperm, do I have to schedule a fertility consult first?
Some providers who prescribe gender-affirming hormones feel comfortable reviewing your sperm analysis results. Others will recommend a consult with a fertility provider to review your results, determine your future family building goals and make recommendations about how much sperm to freeze.