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Low total motile sperm in transgender women seeking hormone therapy

  • Assisted Reproduction Technologies
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Abstract

Purpose

This study was undertaken to compare semen quality, hormonal status, and social factors in transgender women seeking fertility preservation with those of fertile cisgender men. Long-range goals are to establish standard practice measures ensuring optimum semen quality for cryopreservation and fertility preservation in transgender women.

Methods

This is a case-control study carried out at an academic medical center. Cases are transgender women seeking fertility preservation prior to initiation of hormone therapy. Controls are cisgender men recently fathering a child. All participants completed the Depression Anxiety Stress Scales 21 survey and additional survey questions related to personal behaviors. Complete semen analysis was carried out in a clinical andrology laboratory according to WHO guidelines, 5th edition. Serum follicle stimulating hormone, estradiol, and testosterone were measured at the time of semen analysis.

Results

Sperm concentration, total sperm per ejaculate, total motile sperm, volume, and normal sperm morphology were significantly lower in transgender females compared with fertile cisgender men. Other measures of semen parameters and hormone concentrations were not different between groups. Survey results indicated transgender women were more likely to have symptoms of depression, anxiety, and stress and utilize tucking and tight undergarments, compared with controls; however, both groups reported similar numbers of ejaculations per week.

Conclusions

Although semen parameters were low, cryopreservation of sperm prior to hormone therapy is a viable fertility preservation option for most transgender women. The etiology of the differences in semen parameters is not known. Enhanced education related to personal behaviors or treatment to reduce effects of stressors prior to cryopreservation may improve future fertility potential.

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Acknowledgments

The authors thank the participants for contributing to this study.

Funding

This study was funded in part by a clinical and multidisciplinary pilot grant from the University of Kansas Medical Center Research Institute.

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Authors and Affiliations

  1. Department of Obstetrics & Gynecology, University of Kansas Medical Center, Kansas City, KS, 66160, USA

    Courtney Marsh, Megan McCracken, Meredith Gray, Judy Gay & Katherine F. Roby

  2. Center for Advanced Reproductive Medicine, University of Kansas Medical Center, Overland Park, KS, 66211, USA

    Courtney Marsh, Megan McCracken, Judy Gay & Katherine F. Roby

  3. Institute for Reproduction and Perinatal Health, University of Kansas Medical Center, Kansas City, KS, 66160, USA

    Courtney Marsh, Ajay Nangia & Katherine F. Roby

  4. Department of Urology, University of Kansas Medical Center, Kansas City, KS, 66160, USA

    Ajay Nangia

  5. Department of Anatomy & Cell Biology, University of Kansas Medical Center, Kansas City, KS, 66160, USA

    Katherine F. Roby

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  1. Courtney Marsh
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  2. Megan McCracken
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  3. Meredith Gray
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  4. Ajay Nangia
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Correspondence to Courtney Marsh or Katherine F. Roby.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Marsh, C., McCracken, M., Gray, M. et al. Low total motile sperm in transgender women seeking hormone therapy. J Assist Reprod Genet 36, 1639–1648 (2019). https://doi.org/10.1007/s10815-019-01504-y

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  • DOI: https://doi.org/10.1007/s10815-019-01504-y

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