Stolk T H R, Asseler J D, Huirne J A F, van den Boogaard E, van Mello N M
Amsterdam UMC, Location Vrije Universiteit Amsterdam, Center of Expertise on Gender Dysphoria, De Boelelaan 1117, Amsterdam University Medical Centers, the Netherlands; Amsterdam UMC, Department of Obstetrics & Gynaecology, Amsterdam, the Netherlands; Amsterdam Reproduction and Development, Amsterdam, the Netherlands.
Amsterdam UMC, Department of Obstetrics & Gynaecology, Amsterdam, the Netherlands; Amsterdam Reproduction and Development, Amsterdam, the Netherlands.
Best Pract Res Clin Obstet Gynaecol. 2023 Mar;87:102312. doi: 10.1016/j.bpobgyn.2023.102312. Epub 2023 Jan 21.
The decision to pursue one's desire for children is a basic human right. For transgender and gender-diverse (TGD) people, gender-affirming care may alter the possibilities to fulfill one's desire for children due to the impact of this treatment on their reproductive organs. We systematically included 76 studies of varying quality describing the desire for children and parenthood; fertility counseling and utilization; and fertility preservation options and outcomes in TGD people. The majority of TGD people expressed a desire for children. Fertility preservation utilization rates were low as there are many barriers to pursue fertility preservation. The most utilized fertility preservation strategies include oocyte vitrification and sperm banking through masturbation. Oocyte vitrification showed successful outcomes, even after testosterone cessation. Sperm analyses when banking sperm showed a lower quality compared to cis male samples even prior to gender-affirming hormone treatment and an uncertain recovery of spermatogenesis after discontinuing treatment.
追求生育子女的愿望是一项基本人权。对于跨性别者和性别多元者（TGD）而言，性别肯定治疗可能会改变其实现生育愿望的可能性，因为这种治疗会对他们的生殖器官产生影响。我们系统地纳入了76项质量参差不齐的研究，这些研究描述了TGD人群对生育子女和为人父母的渴望；生育咨询与利用情况；以及生育力保存方案和结果。大多数TGD人群表达了生育子女的愿望。由于进行生育力保存存在诸多障碍，其利用率较低。最常采用的生育力保存策略包括卵母细胞玻璃化冷冻和通过手淫进行精子冻存。卵母细胞玻璃化冷冻显示出成功的结果，即使在停止使用睾酮后也是如此。在冻存精子时进行的精子分析显示，即使在进行性别肯定激素治疗之前，与顺性别男性样本相比，精子质量也较低，而且在停止治疗后精子发生的恢复情况不确定。
