Ovarian Tissue Culture for Fertility Preservation in Male Transgender Patients After Hormonal Treatment

Abstract

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.