FAMILY-BUILDING FOR TRANSGENDER COUPLES AND INDIVIDUALS

Trans people with eggs who are taking testosterone
Today, there is only limited data regarding the impact of high levels of testosterone on egg health. That’s why we encourage trans and gender diverse individuals who have started gender affirming hormone therapy (GAHT) to stop taking testosterone for at least 3 months prior to fertility treatment so that you have the best possible chance of achieving your fertility and family-building goals.

While there is data on how high levels of testosterone can impact egg health, it is still very limited. At AFMC, in order to have the best chance to achieve your fertility and family-building, we recommend that trans and gender diverse individuals who have started gender affirming hormone therapy (GAHT) with testosterone, stop for at least 3 months prior to fertility treatment.

The egg retrieval portion of IVF requires multiple vaginal ultrasounds and hormone injections to raise their estrogen levels. These estrogen-based hormone injections will generally not cause an increase in chest tissue, nor will they impact vocal tone or beard growth (if testosterone has been taken prior to the process). After doing egg retrieval, you will experience a heavy menstrual cycle.

Trans people with sperm who are taking estrogen
If you are a trans or gender diverse individual who has started gender affirming hormone therapy (GAHT) with estrogen and/or anti-androgens and plans to utilize sperm for fertility treatments, research indicates high levels of estrogen can impact the quality and health of sperm. We highly recommend suspending estrogen treatment for 3-6 months prior to sperm freezing or additional treatments.

Research indicates high levels of estrogen can have an impact on the quality of sperm health. At AFMC, we recommend that trans and gender diverse individuals stop gender affirming hormone therapy (GAHT) with estrogen and anti-androgens for between 3 and 6 months prior to sperm freezing or sperm related treatments.

In order to use sperm for procedures, you are required to produce a sperm specimen for analysis and to produce further sperm specimens for use in treatments. No hormonal medications are generally needed in this process.

Options prior to bottom surgery and while not taking testosterone.
Trans individuals with eggs who have not had bottom surgery and have also not started Hormone Replacement Therapy have many options to consider including intrauterine insemination (IUI), in vitro fertilization (IVF), and reciprocal IVF (Co-IVF).

If you are a trans individual with eggs and have not had bottom surgery, nor Hormone Replacement Therapy, then you have many options to consider to achieve pregnancy, including intrauterine insemination (IUI), in vitro fertilization (IVF), and reciprocal IVF (Co-IVF).

Options prior to bottom surgery and while not taking estrogen.
If you are a trans or gender diverse persson l with sperm and have not had bottom surgery, nor started gender affirming hormone therapy (GAHT) with estrogen and/or anti-androgens, then you have many options to consider to build your biological family. If your partner has eggs and is able to and planning on carrying a pregnancy, options include intrauterine insemination (IUI) and in vitro fertilization (IVF). If your partner has eggs and is not planning on or able to carry a pregnancy, options include IVF with a gestational surrogate.

If your partner has sperm, options include in vitro fertilization (IVF) in conjunction with egg donation and gestational surrogacy. IVF can be performed with sperm from one of the partners, or both partners, in what is known as a “split cycle.”

In order to use sperm for procedures, you are required to produce a sperm specimen for analysis and to produce further sperm specimens for use in treatments. No hormonal medications are generally needed in this process.

At AFMC, we are here to help trans and gender diverse individuals and couples build their families regardless of where they are in their transition. If you and/or your partner have already undergone bottom surgery and no longer produce gametes, our team of experts will assist you in finding an egg and/or sperm donor.

If needed, our team can also assist you in finding a gestational surrogate. The team at AFMC works with a concierge service that expertly guides intended people through the surrogacy process. The team organizes the medical screening of potential surrogates, reviewing candidates to help determine eligibility, and coordinates treatment and transfer cycles between the egg donor and surrogate.