How can you prevent infertility if you are trans* and opting for medical transition?

• Because hormone therapy can decrease your chances of having biogenetically related children in the future, you may want to consider options for preserving your fertility.

• Hormone therapy (both testosterone(s) and estrogen(s)) suppresses your fertility and can lead to a complete loss of fertility over time. Generally, longer hormone therapy leads to increased loss of fertility.

• Nevertheless, hormone therapy is not a sufficient contraceptive.

• In some cases, fertility can be restored by stopping hormone therapy, but this is not the case for everyone.

• If you have eggs, you can consider freezing them to preserve your fertility. This requires self-injecting fertility drugs to stimulate your ovaries and surgery to remove the eggs. It also requires examinations by vaginal ultrasound. Some health insurances will cover the costs of egg freezing for trans people.

• If you have sperm, you can freeze a sample. Sperm can be collected by ejaculation. It is also possible to extract sperm surgically. Some health insurances will cover the costs of sperm freezing for trans people.

• It is most effective to freeze eggs or sperm prior to starting hormone therapy[1].

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[1] These guidelines are based on information from the Human Fertilization and Embryology Authority (HFEA) (2019) which can be accessed here.