6 Facts You Need to Know About Trans Fertility & Family Building

trans-couple

If you are considering taking hormonal or surgical steps towards transitioning, one of the most important things to consider is cryopreservation of either your eggs or your sperm prior to the start of hormone blockers or surgical procedures that may impact your fertility. Keep reading for six important facts you should know about this process.

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6 Trans Fertility & Family Building FAQs

Along with other unique challenges and considerations, trans folks who desire to have children in the future must also take into account the impact of hormonal or surgical steps before transitioning.

Cryopreserving (freezing) eggs or sperm is a great option to consider, since preserved gametes (eggs or sperm) can be used in the future to help complete a biological family-building journey – whether you’re single or partnered at that time. We’ve pulled together a list of facts and questions that will help you better understand the ins and outs of preserving your fertility.

Let's dive in!

I plan on transitioning soon – can I still have a biological child in the future?

Talk to your physician about your options and ask about the possibility of freezing your eggs or sperm before undergoing any hormonal or surgical treatment that may affect your fertility. If you wish to keep the door open to future biological family building, make sure your care team knows and can provide accurate, timely guidance.

What does the sperm freezing process involve?

The process of sperm freezing involves a semen analysis (to evaluate your specimen before freezing), and bloodwork around the time that you freeze sperm. Fertility practices are evaluated by the FDA, and this testing will allow you to use your frozen specimen in the future.

How much sperm should you freeze? This will depend on many factors indicated by your initial semen analysis report. Your fertility specialist will be able to help you determine how many samples you should cryopreserve.


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What does the egg freezing process involve?

Compared to freezing sperm, the egg-freezing process is a little bit more complicated – but is very common, so you should not have trouble finding a board-certified reproductive endocrinologist who is able to help you.

You would first take a few tests to evaluate your baseline fertility levels. Then, you would take fertility medication over the span of two weeks in order to ready your ovaries for a short in-house procedure called a transvaginal “egg retrieval.”

You would also have to complete bloodwork around the time you freeze your eggs. Fertility practices are evaluated by the FDA, and completing this bloodwork will allow you to use those frozen eggs in a future conception cycle.

How long can eggs and sperm stay frozen?

To date, there is no known limit to how many years specimens can be cryopreserved. This allows trans people the opportunity to preserve their fertility early on in life, and then pursue family building in their 30s or 40s or whenever they are ready to grow their family.

Of course, your family-building plan will need to be personalized for you and your partner (if applicable). A chat with a reproductive endocrinologist is a good first step to build that plan and get all of your questions answered.

I haven’t cryopreserved my eggs or sperm - what should I do?

Talk to your physician about your fertility options. They may refer you to chat with a fertility specialist to help plan your personal fertility and family building journey – which may include freezing eggs or sperm.

What are my future options for using frozen eggs or sperm?

If you've already transitioned (or are in the process of transitioning) and are curious about what your future family-building options will look like, keep reading to learn about the different pathways that may be available to you.

Sperm cryopreservation_transgender

If you identify as a trans woman (MTF or male-to-female), and have frozen sperm, there are a few options if you’re considering a biological family building journey:

    • If you’re in a relationship with a cisgender female, you can use your sperm and your partner’s eggs to undergo IUI or IVF.
    • If you’re in a relationship with a cisgender man, you can use an egg donor and gestational carrier (surrogate) to create embryos with one or both of your sperm, and complete a pregnancy journey.
    • If you’re single, you can use an egg donor and a gestational carrier (surrogate) to create embryos and complete a pregnancy journey.

egg cryopreservation_transgenderIf you identify as a trans man (FTM or female-to-male) and have frozen eggs, there are a few options if you’re considering a biological family building journey:

    • If you’re in a relationship with a cisgender woman, you can use your eggs and donor sperm to complete a reciprocal IVF cycle.
    • If you’re in a relationship with a cisgender man, you can use donor or your partner’s sperm to complete a pregnancy journey. Some of these journeys may require a gestational carrier.
    • If you’re single, you can use donor sperm to complete a pregnancy journey. This may require a gestational carrier.

If you don’t think your personal situation fits into any of the categories above – not to worry! The first step to building your plan is to chat with a fertility specialist, who will help you navigate your personal path to parenthood.


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Fertility Preservation for Trans Persons

Finding a provider that is LGBTQ-friendly is important – family and fertility are personal topics, and you should feel as comfortable as possible as you embark on your path to parenthood. One tool that I recommend for choosing an LGBTQ-friendly practice is the Healthcare Equality Index (HEI) put out each year by the Human Rights Campaign.

Gay Parents To Be and Illume Fertility have been named an HEI leader for the last six years in a row, highlighting our continued dedication to upholding the highest standards of LGBTQ+ inclusivity for patients & staff.

You have many options for fertility preservation and family-building as a trans person, and deserve the highest level of care as you work to grow your family! I wish you all the best on your journey.

More Resources

Dr. Mark P. Leondires

Dr. Mark P. Leondires

Dr. Mark P. Leondires is the Founder and Medical Director of Illume Fertility, a fertility clinic with 5 locations in Connecticut and New York. Dr. Leondires is board-certified in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility.

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