A transgender man, a cisgender woman, and assisted reproductive technologies: a Brazilian case report

Abstract

Transgender men are individuals who identify as men but were assigned female at birth. Gender-affirming medications include testosterone hormone therapy, known for its diverse effects throughout the body, which include endometrial atrophy and the induction of amenorrhea by suppressing ovulation, without however affecting the ovarian follicle pool. This paper reports the first case in Brazil involving a transgender man and a cisgender woman attempting to form a family. A 34-year-old transgender man and a 28-year-old woman came to our assisted reproduction service. He had been on testosterone for two years. At their initial consultation, testosterone therapy was discontinued. Controlled ovarian stimulation for the transgender man was achieved using a combination of recombinant gonadotropins FSH and LH. Pituitary blockage was performed using a GnRH antagonist protocol. Twenty follicles were aspirated and 16 oocytes were retrieved, 12 of which mature. They were inseminated with donor semen. On the fifth day of development, one high quality blastocyst was transferred to the cisgender woman, resulting in an ongoing pregnancy. Five supernumerary embryos were cryopreserved. Controlled ovarian stimulation with high quality oocytes, high quality embryos, and clinical pregnancy are possible for transgender men, even with a history of testosterone use.

Successful In Vitro Fertilization in a Cisgender Female Carrier Using Oocytes Retrieved From a Transgender Man Maintained on Testosterone

“…Five (25%) of the patients who had taken testosterone used assisted reproduction to get pregnant. 6 Assisted reproduction has been a revolutionary tool for LGBTQ people, including trans people.9 In vitro fertilization (IVF), wherein oocytes are harvested and combined with sperm to create an embryo that is then transferred into a uterus, has been a strategy for transgender men seeking biological reproduction.2 , 6 Reciprocal, or co-IVF, is the process by which individuals provide oocytes for implantation into their cis-gender partners' uteri, or in other people with a uterus who agree to carry a pregnancy (also J o u r n a l P r e -p r o o f known as a gestational carrier or a surrogate). Co-IVF has been used in lesbian couples with good reproductive success.10 , It has also been used with success in transgender men donating an oocyte to cisgender female partners.6…”

Gap and proposals for educational practices of sexual and reproductive health for the LGBTQIA+ population: an integrative review / Lacunas e propostas de práticas educativas de saúde sexual e reprodutiva para população LGBTQIA+: revisão integrativa

“…5 Other realities demonstrate the invisibility of promoting the sexual and reproductive health of the LGBTQIA+ population, such as the lack of knowledge and guidance on the part of health professionals regarding the assisted reproduction methods available to this public and instructions on care and techniques for maintaining gametes when hormonal therapies are chosen for the transsexualizing process. 6 Furthermore, adherence to erroneous popular knowledge, which explains lesbian women's "immunity" to sexually transmitted infections, hinders prevention and favors an increase in health problems in this group. 7 Therefore, given the invisibility and rights to sexual and reproductive health of LGBTQIA+ people, considering the hypothesis of the incipience of actions and practices aimed at promoting sexual and reproductive rights and sexual and reproductive health of this public, this research aimed to analyze national scientific publications on sexual and reproductive health care offered to the LGBTQIA+ population in relation to the main gaps and possibilities of educational practices related to this theme in the Brazilian context.…”