Racine IVF Unit, Fertility Institute, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 6423906, Tel Aviv, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Reprod Sci. 2022 Jan;29(1):260-269. doi: 10.1007/s43032-021-00561-y. Epub 2021 Mar 31.
The present study aimed to determine the semen quality and cryopreservation outcomes among adolescent transgender females at the time of fertility preservation (FP) before initiating gender-affirming hormone (GAH) treatment. This retrospective cohort study included 26 adolescent transgender females who underwent FP in our Fertility Institute between 06/2013 and 10/2020. Pre-freezing semen parameters were compared to WHO 2010 reference values. Post-thaw semen parameters were used to determine the adequate assisted reproductive technology (ART). A multivariate linear regression analysis was performed to assess the impact of medical and lifestyle factors on semen quality. The mean age at which adolescent transgender females underwent FP was 16.2 ± 1.38 years. The median values of all semen parameters in our study group were significantly lower compared to the WHO data, including volume (1.46 mL vs 3.2 mL, respectively, P = 0.001 ), sperm concentration (28 × 10/mL vs 64 × 10/mL, P < 0.001), total sperm number (28.2 × 10 vs 196 × 10, P < 0.001), total motility (51.6% vs 62%, P < 0.001), and normal morphology (2% vs 14%, P < 0.001). The frequency of semen abnormalities was teratozoospermia 72%, hypospermia 52%, oligozoospermia 28%, and azoospermia 4%. The median post-thaw total motile count was 0.17 × 10/vial, and the quality was adequate only for ICSI in 87.7% of the thawed semen samples. No correlation was found between selected medical and lifestyle factors and poor semen parameters. Semen quality is strongly reduced among adolescent transgender females before hormone therapy and their stored sperm samples are suitable for intracytoplasmic sperm injection (ICSI) rather than conventional IVF/intrauterine insemination (IUI).
本研究旨在探讨在开始性别肯定激素（GAH）治疗前进行生育保存（FP）时，青春期跨性别女性的精液质量和冷冻保存结果。这项回顾性队列研究纳入了 2013 年 6 月至 2020 年 10 月期间在我们的生育研究所接受 FP 的 26 名青春期跨性别女性。比较了冷冻前的精液参数与世界卫生组织（WHO）2010 年的参考值。使用解冻后的精液参数来确定足够的辅助生殖技术（ART）。进行了多变量线性回归分析，以评估医疗和生活方式因素对精液质量的影响。青春期跨性别女性进行 FP 的平均年龄为 16.2 ± 1.38 岁。与 WHO 数据相比，本研究组的所有精液参数的中位数均显著降低，包括体积（分别为 1.46 毫升和 3.2 毫升，P = 0.001）、精子浓度（分别为 28×10/ml 和 64×10/ml，P < 0.001）、总精子数（分别为 28.2×10 和 196×10，P < 0.001）、总活力（分别为 51.6%和 62%，P < 0.001）和正常形态（分别为 2%和 14%，P < 0.001）。精液异常的频率为畸形精子症 72%、少精子症 52%、弱精子症 28%和无精子症 4%。解冻后总活动精子计数的中位数为 0.17×10/管，解冻后的精液样本中只有 87.7%适合进行胞浆内单精子注射（ICSI）。选择的医疗和生活方式因素与不良精液参数之间没有相关性。在接受激素治疗之前，青春期跨性别女性的精液质量严重下降，他们储存的精子样本适合胞浆内单精子注射（ICSI），而不适合常规体外受精/宫腔内人工授精（IUI）。
