Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Washington University in Saint Louis, Saint Louis, Missouri.
Division of Endocrinology and Diabetes, Department of Pediatrics, Washington University in Saint Louis, Saint Louis, Missouri.
Fertil Steril. 2021 Aug;116(2):522-527. doi: 10.1016/j.fertnstert.2021.02.025. Epub 2021 Mar 29.
To report a successful case of ovarian hyperstimulation and oocyte cryopreservation in a transgender male adolescent after suppression with a gonadotropin-releasing hormone (GnRH) agonist while using the aromatase inhibitor letrozole to maintain low serum estradiol.
Case report.
Division of Reproductive Endocrinology and Infertility, Washington University in St. Louis School of Medicine, St Louis, Missouri.
PATIENT(S): A 15-year-old Tanner II transgender male adolescent with a GnRH agonist implant.
INTERVENTION(S): The GnRH agonist implant was removed. The patient was given letrozole (5 mg daily) while undergoing ovarian stimulation with an antagonist protocol. After oocyte retrieval, the patient began taking testosterone.
MAIN OUTCOME MEASURE(S): Successful oocyte cryopreservation with minimal changes in breast budding.
RESULT(S): The patient's peak serum estradiol concentration was 510 pg/mL. Twenty-two mature oocytes were cryopreserved. Small increases in breast budding occurred between baseline and the time of oocyte retrieval.
CONCLUSION(S): We successfully used letrozole to maintain low serum estradiol in a transgender male adolescent during ovarian stimulation. Maintaining low estradiol to minimize pubertal development and possibly prevent gender dysphoria symptoms may make oocyte cryopreservation more desirable for transgender male adolescents.
报告 1 例 GnRH 激动剂抑制下使用芳香化酶抑制剂来曲唑维持低血清雌二醇水平，对跨性别男性青少年进行卵巢刺激和卵母细胞冷冻保存的成功案例。
病例报告。
密苏里州圣路易斯华盛顿大学医学院生殖内分泌与不孕不育科。
15 岁，Ⅱ期 Tanner 跨性别男性青少年，使用 GnRH 激动剂植入物。
取出 GnRH 激动剂植入物。患者接受拮抗剂方案的卵巢刺激时，给予来曲唑（每天 5 毫克）。取卵后，患者开始服用睾酮。
卵母细胞冷冻保存成功，乳房发育变化最小。
患者血清雌二醇浓度峰值为 510 pg/ml。冷冻保存了 22 个成熟卵母细胞。在取卵前，乳房发育略有增加。
我们成功地在 GnRH 激动剂抑制下使用来曲唑维持跨性别男性青少年的低血清雌二醇水平。维持低雌二醇以最大限度地减少青春期发育，并可能预防性别焦虑症状，可能使卵母细胞冷冻保存更受跨性别男性青少年的欢迎。
