Fertility & Preservation
* trans person may find themselves in a discussion with a doctor or endocrinologist about fertility preservation when they are going on hormone blockers, and/or starting other hormones such as testosterone ("T") or estrogen.
The last section includes resources on transgender pregnancies.
FERTILITY & PRESERVATION
* OTHER PROVINCES
* US / INTERNATIONAL
FERTILITY & PRESERVATION
PCRM (Pacific Centre for Reproductive Medicine). Edmonton.
"The Pacific Centre for Reproductive Medicine (PCRM) is focused on your needs with our comprehensive IVF and reproductive medical care"
Fertility page. https://pacificfertility.ca/fertility
* Egg Freezing: Eggs can be frozen at their best quality and used to make a family in the future
* Sperm Freezing: Sperm can be frozen and stored for future use with insemination (IUI) or in vitro fertilization (IVF)
Regional Fertility Program, Calgary.
Situations may arise in which a person’s future ability of having his or her own biological child may be in jeopardy. Treatments are available at the Regional Fertility Program for both male and female patients facing such a challenge.
ALBERTA ENDOCRINOLOGIST RESPONSE WHEN ASKED ABOUT FERTILITY PRESERVATION
One of our Pflag attendees questioned their endocrinologist for their opinion on fertility preservation. This is their doctor's response:
"There are some anatomy terms in here as I write about the specific scenarios.
For transmen or NB/transmasc folks taking testosterone at doses high enough to stop menstrual cycles, it does seem that menstrual cycles will resume, at least being able to go through the egg stimulation and retrieval process, if testosterone is stopped. There is a recent study that described individuals up to 17y on testosterone successfully going through the egg retrieval process and then either themselves (minority) or a partner carrying a pregnancy (egg would have been fertilized in a clinic). There is no data to say what the success rate of that is i.e. if 100 people who had also been on testosterone for 17y went through the same process of stopping testosterone and stimulating eggs- would 100% be successful with it, or 70% or 50%? Also do not know how many are able to stop testosterone, have cycles restart and get pregnant themselves, but the above data does suggest that ovaries will resume function and that eggs remain.
However, ovarian reserve (how many eggs there are) goes down with age, and more medications might be needed to stimulate more eggs for retrieval as people get older --- so the cost goes up, and the number of eggs that can be retrieved goes down. So if thinking about egg preservation (if it's important to them), it is good to do early.
So the main message is that is does seem that ovaries are likely functional once testosterone is stopped, assuming age is pre-menopausal. Also, testosterone does not always suppress ovulation, so contraception is still important depending on sexual partner.
For transwomen or NB/transfem individuals there is less objective data about recovery if HRT is stopped. Sperm count does fall as testosterone levels come down so that could be in 6 months or in a yea. it depends on medication doses and response to them --- mostly what happens to testosterone in terms of sperm production. Anecdotally, a couple of individuals I've been following stopped HRT after ~2years and saw sperm count recover. However, there is structural change to the testes over time if very little to no testosterone is produced. i.e. the testes get smaller as the cells atrophy so there is probably a point when both sperm and testosterone production would not recover, or only partially. This also happens to cis-men who are taking testosterone for whatever reason as their own production is turned off by the medication and testes shrink. But there is no data to say what that timeline is, as I suspect it varies from one person to the next, so could be 2 years or 5 years.
So it really is a good idea to bank sperm prior to starting or as early as possible (does mean stopping any HRT if started already)."
(Transgender children - numerous topics)
Posted on Gender Creative Kids website. Montreal, QC.
Sections include: personal stories / trans women / trans men / non-binary / fertility preservation / lactation / research / BIPOC stories / cesarean birth stories / home birth stories / IVF / postpartum / gender creative parenting.
Reproductive options for trans people
Created by Rainbow Heath Ontario. FACT SHEET.
“This fact sheet offers information about reproductive options for trans people interested in hormone therapy or surgeries. Knowing and discussing reproductive options is a necessary component of informed consent to transition-related care, and is a significant component of the World Professional Association for Transgender Health’s (WPATH) Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People.”
Sherbourne’s Guidelines for gender-affirming primary care with trans and non-binary patients: 4th edition
By Dr. Amy Bourns, a family physician on Sherbourne’s LGBT2SQ Health Team. 4th edn, 2019. (Ontario)
“In addition to incorporating recently available evidence in both general primary care and trans health, the 2019 edition features revisions and expansions in several areas, including: expanded discussion of considerations for non-binary patients; unique considerations for older trans patients; subtle language changes that reflect the rapid pace of cultural change; an expanded discussion of fertility considerations for trans people; discussion of alternate routes of hormone administration; an overview of the role of PCPs in supporting patients with transition-related surgeries; and The Trans Primary Care Guide, the online interactive tool based on the Guidelines, has also been updated… You may also want to access the Quick Reference Guide that was created to accompany the full Guidelines.”
US / INTERNATIONAL
Everything you ever wanted to know about transgender fertility
By Trans Fertility Co.
"A project of Collaborate Consulting, Trans Fertility Co. is the brainchild of trans gestational parent and fertility educator Trystan Reese. After going through his own pregnancy with little access to data on trans fertility, he committed himself to building resources for trans people and their supporters. Here, you’ll find articles on academic research, videos on many aspects of trans fertility, and opportunities for fertility and family-building practitioners to deepen their commitment to the trans community."
Transmasculine adolescent fertility breakthrough: Successful egg retrieval following puberty blockers since Tanner 2 and direct continuation to testosterone
By Zinnia Jones. Gender Analysis web series. May 31, 2021. (US)
PREGNANCY & PARENTING NEWBORNS
Pregnancy and parenting: Our adventures in fertility, pregnancy, and parenting as a queer and trans couple
By Meaghan Ray. Purple and Green and the Life In Between. Blog posts. (Alberta)
"...a blog about being gender queer/non-binary, having a partner who transitions, our journey through fertility, pregnancy, and parenting, and musings about the gendered aspects of society"
Supporting a transgender parent with chestfeeding: A case study on cultural safety
Alberta Health Services. 2019.
"This case study focuses on how you can support a transgender parent in ways that contribute to a culturally safe experience. Use the LEARN model to guide supportive conversations with parents.
Recommendations and management strategies for most factors that influence breastfeeding or chestfeeding and weaning are the same for transgender and cisgender parents. As with all parents, respectful and effective lactation support or the transgender parent includes early awareness about the parent’s preferences and feeding goals."
Where’s the mother? Stories from a transgender dad
by Trevor MacDonald. 2016. (Manitoba)
“In a time when to most people ‘pregnancy’ automatically means ‘motherhood’,” what is it like to get pregnant, give birth, and breastfeed a child all while being an out transgender man? When Trevor MacDonald decided to start a family, he knew that the world was going to have questions for him. As a transgender man in a gay relationship, Trevor has gone through the journeys of pregnancy, childbirth, and nursing all while exploring (and sometimes defending) his role as a trans dad. Trevor and his partner tackle all the questions new parents are familiar with, such as: Should we feed our baby breast milk or formula? Should we have a hospital or home birth? Other questions are much less familiar: How can a man cope with gender dysphoria when going through such female-coded rituals as childbirth and breastfeeding? How can a person breastfeed after having had chest masculinization surgery? How do we find donor milk to supplement our own modest milk supply? Luckily for the reader, Trevor explains his own answers to these questions with grace and humour. His stories convey the intimate and sometimes surprising realities of the transgender parenting experience. This memoir is a book about being a breastfeeding parent and a transgender man, and the many beautiful, moving, and difficult ways these two identities collide. It shows us that, ultimately, the parenting journey is beyond all our assumptions and preconceptions. “Where’s the Mother?” is a memoir about love and family like no other.”
Trevor’s “Milk Junkies” website: Breastfeeding and parenting from a transgender perspective.
US & INTERNATIONAL
How we do family: From adoption to trans pregnancy, what we learned about love and LGBTQ parenthood (book)
By Trystan Reese, creator of “Trans Fertility Co.” June 2021.
“When Trystan Reese was just a year into his relationship with Biff (now his husband), the couple learned that Biff”s niece and nephew were about to be removed from their home by Child Protective Services. Immediately, Trystan and Biff took in one-year-old Hailey and three-year-old Lucas, becoming caregivers overnight to two tiny survivors of abuse and neglect. From this surprising start, Trystan and Biff built a loving marriage and happy home – learning to parent on the job. They adopted Hailey and Lucas, and soon decided to grow their family biologically with a child that Trystan, who is transgender, would carry. Trystan’s groundbreaking pregnancy attracted media fanfare, and the family welcomed baby Leo in 2017. In How We Do Family, Trystan shares their unique story and what he”s learned about being the best parent, partner, and person you can be. Through crisis, adoption, pregnancy-and all the usual challenges of parenting – Trystan shows that more important than getting things right is doing them with love.” See also resource below for Trans Fertrility Co. a project of Collaborate Consulting, Trystan’s website.
By Trystan Reese of Collaborative Consulting. Website. (US)
“Everything you ever wanted to know about transgender fertility. A project of Collaborate Consulting, Trans Fertility Co. is the brainchild of trans gestational parent and fertility educator Trystan Reese. After going through his own pregnancy with little access to data on trans fertility, he committed himself to building resources for trans people and their supporters. Here, you’ll find articles on academic research, videos on many aspects of trans fertility, and opportunities for fertility and family-building practitioners to deepen their commitment to the trans community.” Check this site for their medical resources for all non-cisgender persons.
Click for FACEBOOK page.