Lateral hemostatic sutures do not affect the amount of intraoperative bleeding or the number of postoperative interventions. Their use is not necessary because they result in longer operative time, have a higher cost due to the use of suture material and pose the risk of ureter lesion in case the sutures are not placed at a lower position in the cervix. ClinicalTrials. gov identifier: NCT02184975.

Objective To evaluate the reproductive and histological characteristics of fresh cultured ovarian tissue from transgender male patients. Methods An in vitro pilot study in which samples were collected during sex reassignment surgery for transgender male patients. The ovarian cortex was cut into fragments of 2 mm, 3 mm, and 4 mm, and placed in a 96-well plate suitable for cultivation at days 0, 2, 4, 6, and 8, when the histology was analyzed. Results Stromal hyperplasia was observed in all samples, and it was not associated with the obtainment of primordial or primary follicles. Peripheral reduction in cell count was also a recurrent finding. Primordial and primary follicles were identified with a heterogeneous pattern in fragments from the same patient and from different patients, and follicles in more advanced stages of development (secondary and antral) were not found. There was an association between the diameter of the ovarian fragments and the identification of primary follicles (p = 0.036). The number of days in culture was associated with histological signs of tissue damaging in the fragments (p = 0.002). The total number of follicles identified in the samples with 2 mm in diameter was significantly lower than in those that measured 4 mm in diameter (p = 0.031). Conclusion A diameter of 4 mm is suitable for ovarian tissue culture with the benefit of ease of handling. Even after prolonged exposure to testosterone, the ovarian fragments presented primordial and primary follicles, maintaining viability throughout the days they were exposed to the culture. Freezing the ovarian cortex of transgender patients who will undergo surgery for gender reassignment would be an interesting option, in the future, for the preservation of fertility.

The aim of this study was to evaluate the reproductive and histological characteristics of fresh cultured ovarian tissue from transgender male patients. Methods: In vitro experimental study. Samples were collected during sex reassignment surgery for male transgender patients. Ovarian cortex was cut into fragments of 2, 3 and 4 mm and placed in a 96-well plate suitable for cultivation at days zero, 2, 4, 6 and 8, when the histology was analyzed. Results: Stromal hyperplasia was observed in all samples. Presence of stromal hyperplasia was not associated with obtaining primordial or primary follicles. Peripheral reduction in cells number was also a recurrent finding. Primordial and primary follicles were identified with a heterogeneous pattern between fragments from the same patient and between different patients, and follicles in more advanced stages of development (secondary and antral) were not found. There was an association between the diameter of the ovarian fragments and the identification of primary follicles (p=0.036). The number of days in culture was associated with histological signs of tissue suffering in the fragments (p=0.002). The total number of follicles identified in the 2 mm diameter samples was significantly lower than in the 4 mm diameter samples (p=0.031). Conclusion: Even after prolonged exposure to testosterone, ovaries presented primordial and primary follicles, maintaining viability over the days exposed to the culture. Follicles at more advanced stages of development were not identified. These findings suggest that in female to male transgender patients reproductive potential may be preserved to the time of reassignment surgery.