Tsonis Orestis, Kopeika Julia
Specialty Doctor in Assisted Conception, Fertility Preservation Service, Assisted Conception Unit, Guy's Hospital, London, UK.
Consultant Gynaecologist and Subspecialist in Reproductive Medicine and Surgery, Lead of the Fertility Preservation Service, Assisted Conception Unit, Guy's Hospital, London, UK.
Int J Transgend Health. 2023 Nov 24;25(4):663-680. doi: 10.1080/26895269.2023.2284775. eCollection 2024.
Transgender and non-binary individuals face unique challenges when it comes to fertility preservation (FP). Despite the growing prevalence of gender dysphoria (GD) and gender transitioning, there is a lack of clear guidelines and consensus on the management of these patients in the FP setting. Clinicians and institutions providing FP services should ensure that they are aware of the needs and circumstances of this underrepresented group of patients and offer them accurate and evidence-based information when counseling and tailoring their FP treatment. For this scoping review, three major search engines were used. Including Embase, Epistemonikos, Google Scholar, MEDLINE and PubMed. Sources of grey literature were also explored (ResearchGate and Web of Science). The combination of only two keywords [transgender] AND [fertility preservation] was used up to May 2023. The available evidence on clinical management and FP outcomes in transgender patients is limited and mainly originates from case reports or small case series. The main limitation of current FP services for transgender and non-binary individuals is the lack of scientific evidence regarding their care. Overall, FP in transgender patients requires individualized and realistic plans, and psychological counseling should be offered. This review aims to provide the latest evidence coming from original studies to facilitate proper counseling and fertility management for these individuals. Inclusive health systems that provide comprehensive reproductive health care to transgender individuals can help them make informed decisions about FP and improve their quality of life. Future research is needed to establish more robust evidence-based guidelines for the management of transgender and non-binary individuals in the FP setting.
跨性别者和非二元性别者在生育力保存(FP)方面面临独特的挑战。尽管性别焦虑症(GD)和性别转换的患病率不断上升,但在FP背景下对这些患者的管理缺乏明确的指导方针和共识。提供FP服务的临床医生和机构应确保了解这一代表性不足的患者群体的需求和情况,并在为他们提供咨询和量身定制FP治疗时,为他们提供准确且基于证据的信息。对于本范围综述,使用了三个主要搜索引擎,包括Embase、Epistemonikos、谷歌学术、MEDLINE和PubMed。还探索了灰色文献来源(ResearchGate和科学网)。截至2023年5月,仅使用了两个关键词的组合[跨性别者]和[生育力保存]。关于跨性别患者临床管理和FP结果的现有证据有限,主要来自病例报告或小型病例系列。目前为跨性别者和非二元性别者提供的FP服务的主要局限性在于缺乏关于他们护理的科学证据。总体而言,跨性别患者的FP需要个性化且现实的计划,并应提供心理咨询。本综述旨在提供来自原始研究的最新证据,以促进为这些个体提供适当的咨询和生育管理。为跨性别者提供全面生殖健康护理的包容性卫生系统可以帮助他们就FP做出明智的决定,并提高他们的生活质量。未来需要开展更多研究,以建立更有力的基于证据的指导方针,用于FP背景下跨性别者和非二元性别者的管理。