跨性别男性患者卵巢刺激过程中睾酮管理：挑战常见实践以满足患者需求——2 个病例报告。
Management of testosterone around ovarian stimulation in transmasculine patients: challenging common practices to meet patient needs-2 case reports.
机构信息
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.
Anova Fertility and Reproductive Health, North York, Ontario, Canada.
出版信息
Hum Reprod. 2023 Mar 1;38(3):482-488. doi: 10.1093/humrep/dead003.
Approximately 50% of transmasculine people use testosterone for gender affirmation, yet very little is known about the effects of testosterone on future reproductive capacity. Moreover, there are no data to guide fertility specialists on how to manage testosterone leading up to or during ovarian stimulation. Most clinics require cessation of testosterone prior to ovarian stimulation in this setting of no data; however, the current literature does suggest a potential increase in dysphoria with cessation of testosterone and during stimulation. This divergence begs the question of whether clinicians may be doing more harm than good by enacting this requirement. Here, we present two cases of transmasculine individuals who were on testosterone prior to stimulation and maintained their testosterone dosage throughout stimulation as proof of concept, followed by a discussion of current clinical practice and providing some rationale to support continuation of testosterone throughout stimulation.
大约 50%的跨性别男性使用睾丸素来进行性别认同，但对于睾丸素对未来生育能力的影响知之甚少。此外，没有数据可以指导生育专家如何在没有数据的情况下管理睾丸素，以进行卵巢刺激。大多数诊所要求在这种情况下停止睾丸素刺激；然而，目前的文献确实表明，在停止睾丸素和刺激期间，可能会增加不适。这种差异提出了一个问题，即临床医生是否通过执行这一要求而弊大于利。在这里，我们提出了两个案例，即两个在刺激前就已经使用睾丸素的跨性别男性，他们在刺激期间维持了他们的睾丸素剂量，以此作为概念验证，随后讨论了当前的临床实践，并提供了一些支持在整个刺激期间继续使用睾丸素的基本原理。
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