Fertility Preservation for Transgender and Gender-diverse Individuals: Current Practices and Future Directions

It is recommended that transgender individuals undergo fertility preservation counseling before initiating gender-affirming hormone therapy and gender-affirming surgery. Counseling should include reviewing both the short-term and long-term impacts of medical and surgical therapy on fertility, as well as fertility preservation and assisted reproduction options for current or future reproduction. Fertility preservation options for transgender males include embryo, oocyte, and ovarian tissue cryopreservation, and options for transgender females include sperm cryopreservation. Testicular tissue cryopreservation is the only option available for prepubertal males and is considered experimental at this time.