TY - JOUR
T1 - Ovarian tissue cryopreservation in female-to-male transgender people
T2 - insights into ovarian histology and physiology after prolonged androgen treatment
AU - De Roo, Chloë
AU - Lierman, Sylvie
AU - Tilleman, Kelly
AU - Peynshaert, Karen
AU - Braeckmans, Kevin
AU - Caanen, Mirte
AU - Lambalk, Cornelius B.
AU - Weyers, Steven
AU - T'Sjoen, Guy
AU - Cornelissen, Ria
AU - De Sutter, Petra
PY - 2017/6/1
Y1 - 2017/6/1
N2 - Female-to-male transgender people (trans men) are faced with the risk of losing their reproductive potential owing to gender-affirming hormone treatment and genital reconstructive surgery. This observational, prospective cohort study investigates the effect of prolonged androgen therapy on their ovarian histology and fertility preservation perspectives. Hormone serum levels, ovarian histology and cumulus-oocyte complexes (COC) of 40 trans men were analysed at the moment of hysterectomy with bilateral oophorectomy in the context of genital reconstructive surgery after testosterone treatment (58.18 ± 26.57 weeks). In the cortex, most follicles were primordial (68.52% total follicle count) compared with 20.26% intermediate and 10.74%primary follicles. Few secondary follicles (0.46%) and a single antral follicle were found in the sections analysed. In total, 1313 COC were retrieved from the medulla of 35 patients (37.51 ± 33.58 COC per patient). Anti-Müllerian hormone serum levels were significantly correlated with number of COC (Rs 0.787, P < 0.001). After 48 h in-vitro maturation, 34.30% metaphase II oocytes were obtained, with 87.10% having a normal spindle structure. In conclusion, the cortical follicle distribution in trans men, after more than a year of testosterone treatment, seems to be surprisingly normal. This work confirms the presence and in-vitro maturation potential of cumulus-oocyte complexes.
AB - Female-to-male transgender people (trans men) are faced with the risk of losing their reproductive potential owing to gender-affirming hormone treatment and genital reconstructive surgery. This observational, prospective cohort study investigates the effect of prolonged androgen therapy on their ovarian histology and fertility preservation perspectives. Hormone serum levels, ovarian histology and cumulus-oocyte complexes (COC) of 40 trans men were analysed at the moment of hysterectomy with bilateral oophorectomy in the context of genital reconstructive surgery after testosterone treatment (58.18 ± 26.57 weeks). In the cortex, most follicles were primordial (68.52% total follicle count) compared with 20.26% intermediate and 10.74%primary follicles. Few secondary follicles (0.46%) and a single antral follicle were found in the sections analysed. In total, 1313 COC were retrieved from the medulla of 35 patients (37.51 ± 33.58 COC per patient). Anti-Müllerian hormone serum levels were significantly correlated with number of COC (Rs 0.787, P < 0.001). After 48 h in-vitro maturation, 34.30% metaphase II oocytes were obtained, with 87.10% having a normal spindle structure. In conclusion, the cortical follicle distribution in trans men, after more than a year of testosterone treatment, seems to be surprisingly normal. This work confirms the presence and in-vitro maturation potential of cumulus-oocyte complexes.
KW - Anti-Müllerian hormone
KW - Cumulus-oocyte complex
KW - Fertility preservation
KW - In vitro maturation
KW - Ovarian tissue
KW - Transgender
UR - http://www.scopus.com/inward/record.url?scp=85016414109&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.rbmo.2017.03.008
DO - https://doi.org/10.1016/j.rbmo.2017.03.008
M3 - Article
SN - 1472-6483
VL - 34
SP - 557
EP - 566
JO - Reproductive BioMedicine Online
JF - Reproductive BioMedicine Online
IS - 6
ER -