Dr. Saber’s Blog

The Importance of Fertility Preservation Counseling for Trans Men 

September 27, 2024

Fertility preservation counseling is an essential aspect of comprehensive health care for lgbtq+ individuals, including trans men, as gender-affirming treatments might impact their ability to have biological children in the future. 

When trans men are considering things such as hormone therapy or gender-affirming surgery, fertility preservation counseling should be a part of that decision. Transgender individuals should be fully informed about how these treatments can affect their ability to have biological children in the future.  

While fertility preservation counseling is becoming a standard practice in comprehensive health care for transgender patients, there is more to be done. 

The Importance of Fertility Preservation Counseling for Trans Men 

Understanding the impact of treatment options

Future family building and fertility services are critical aspects of transition for transgender and gender non-conforming individuals mainly because things like hormonal therapy and surgery can make it challenging to have biological children later on. 

Testosterone therapy, which trans men commonly use during the female-to-male (FTM) process, can suppress ovulation and cause changes in the ovaries. While some studies have found that some of the impacts of gender-affirming hormone therapy on fertility may be reversible once the treatment is stopped, there is still a risk of permanent infertility. 

Alternatively, gender-transitioning surgeries typically result in permanent infertility. Many trans men undergo surgeries such as hysterectomy (removal of the uterus) or oophorectomy (removal of the ovaries). These treatments often lead to irreversible infertility. Therefore, it is crucial to consider fertility preservation options before these procedures. 

Fertility preservation options for trans men

Several FTM fertility preservation options are available, each with benefits, challenges, and considerations. Choosing which to pursue depends on various factors, including age, health, and family planning goals. 

Oocyte (egg) cryopreservation

Oocyte cryopreservation, known as egg freezing, has become established in assisted reproductive technology (ART). It involves stimulating the ovaries with hormones to produce multiple eggs, which are then retrieved and frozen for future use. 

Ovarian stimulation and egg retrieval allow transmasculine individuals to preserve their eggs before starting testosterone therapy or undergoing surgery. This way, the frozen eggs can later be used for in vitro fertilization (IVF) or with a gestational carrier, offering the possibility of biological children. 

Embryo cryopreservation

Embryo cryopreservation involves fertilizing retrieved eggs with sperm (from a partner or donor) to create embryos. They are then frozen for future implantation with a partner or through surrogacy.  

This fertility treatment has a higher success rate than egg freezing, as embryos are more likely to survive the thawing process and result in successful pregnancies and live births. But like egg freezing, it must also be completed before testosterone treatment or other interventions. 

Ovarian tissue cryopreservation

Ovarian tissue cryopreservation is an emerging reproductive technology where a portion of the ovarian tissue is surgically removed and frozen. This tissue can potentially be reimplanted in the future to restore fertility or used to mature eggs in the laboratory. 

Ovarian tissue cryopreservation is particularly useful for trans men who wish to begin testosterone use before reproductive maturation and the start of their menstrual cycles. Unlike egg or embryo freezing, there is no need for hormonal therapy to stimulate the ovaries. 

Challenges and considerations in the preservation of reproductive options for trans men

While fertility preservation that makes future family building possible offers valuable options for transgender men, it is vital to acknowledge the challenges and considerations involved in this process. 

Emotional and psychological considerations

Fertility preservation can be emotionally challenging for a few reasons. Both egg and embryo cryopreservation involve hormone stimulation, which can cause emotional distress and temporary discomfort.  

Additionally, in the case of embryo cryopreservation, the decision to create embryos involves considering legal and ethical implications, especially regarding the use of donor sperm. Ovarian tissue cryopreservation is still regarded as experimental, and the success rates are not yet well established, which can also result in conflicting emotions. 

All of the fertility preservation options naturally come with a focus on reproductive organs, which can exacerbate gender dysphoria for some trans men. Trans men may experience conflict between the desire to preserve fertility and the urgency to begin hormone treatment or undergo surgery. Fertility preservation counseling and mental health support can provide a space to explore these feelings, prioritize personal goals, and make informed decisions. 

Additional considerations for transgender fertility preservation 

The costs associated with fertility preservation can be significant. Unfortunately, insurance coverage usually does not apply to these procedures, leading to financial strain for some individuals. 

Finding healthcare providers who are knowledgeable about transgender health, gender identity, and fertility preservation can also be challenging. Trans men may need to travel to access these services, which can add to the emotional and financial burden. 

Considering LGBTQ+ Fertility Preservation Options? Consider Dr. Saber 

Access to gender-affirming plastic surgery improves quality of life, mental health, self-image, and overall well-being. That’s why Dr. Sepideh Saber, M.D., is proud to provide a variety of cosmetic surgeries and procedures for trans and nonbinary patients, including breast reduction and removal and transgender body contouring.  

Dr. Speideh Saber is a renowned plastic surgeon based in Los Angeles. She specializes in gender-affirming surgeries and cosmetic procedures. She believes in empowering her patients through knowledge, empathy, and expert care. 

Call us at (877) 205-4100 or schedule a consultation online. 

The practice of Dr. Saber is located in Encino, CA for patients throughout the Los Angeles area. We are also convenient to Encino, Woodland Hills, Sherman Oaks, Calabasas, Burbank, Glendale, Hidden Hills, Agoura Hills, Northridge, North Hollywood, Malibu, Topanga, Canoga Park, Reseda, Valley Glen, Chatsworth, West Hills, Winnetka, Universal City, Bel Air, Beverly Hills, Downtown Los Angeles, Silverlake, and Echo Park. 

Fertility Preservation for Trans Men FAQs

Can I freeze my eggs while on testosterone? 

Because testosterone suppresses egg maturation, transgender men taking testosterone will need to stop hormone therapy and begin menstrual cycles before the egg-freezing process.

Can you produce sperm if you have FTM? 

Transgender men are unable to produce sperm, but there may still be ways to achieve gender-affirming goals, such as ejaculation or natural family building.

Can you stay fertile on HRT? 

While hormone therapy usually makes an individual infertile, studies have shown that breakthrough ovulation is still possible while on testosterone. Because individuals on HRT can still become pregnant, contraception should be considered.

Sources: 

Katrien Wierckx, Eva Van Caenegem, Guido Pennings, Els Elaut, David Dedecker, Fleur Van de Peer, Steven Weyers, Petra De Sutter, Guy T’Sjoen, Reproductive wish in transsexual men, Human Reproduction, Volume 27, Issue 2, 1 February 2012, Pages 483–487, https://doi.org/10.1093/humrep/der406 

Wallace, S. A., Blough, K. L., & Kondapalli, L. A. (2014). Fertility preservation in the transgender patient: expanding oncofertility care beyond cancer. Gynecological Endocrinology, 30(12), 868–871. https://doi.org/10.3109/09513590.2014.920005 

Warton C, McDougall RJ. Fertility preservation for transgender children and young people in pediatric healthcare: a systematic review of ethical considerations. J Med Ethics. 2022 Dec;48(12):1076-1082. doi: 10.1136/medethics-2021-107702. Epub 2022 Jan 3. PMID: 34980674; PMCID: PMC9726968. 

von Vaupel-Klein AM, Walsh RJ. Considerations in genetic counseling of transgender patients: Cultural competencies and altered disease risk profiles. J Genet Couns. 2021 Feb;30(1):98-109. doi: 10.1002/jgc4.1372. Epub 2020 Dec 26. PMID: 33368789; PMCID: PMC7898523. 

X, S. & Rutgers University. (2022, September 6). Fertility preservation counseling needed for transgender men. Medical Xpress.https://medicalxpress.com/news/2022-09-fertility-transgender-men.html 

Dr. Saber graduated from Stanford University’s world-renowned medical school and did her plastic and reconstructive surgery residency at the equally lauded University of Southern California. She then completed a fellowship at New York University in the extremely challenging and delicate disciplines of hand surgery and microsurgery.

Dr. Saber offers a more sensitive, female perspective for patients of all ages, genders, and orientations. Former patients from all walks of life have praised not only their treatment outcomes but her caring, thoughtful approach to a wide array of appearance and health-related matters.
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    I was fortunate to find Dr. Saber after researching board-certified surgeons who specialize in breast cancer reconstruction revision surgery. I knew I was in good hands from the moment I spoke with the lovely and efficient Marlene, Dr Saber's office manager. Dr Saber patiently listened to my concerns and, after examining me, explained what I could realistically expect the outcome to be from another surgery. She also explained to me that she would need to review my previous surgery notes before we could discuss a possible further surgery, which I found comforting and highly ethical. I also discussed a couple of other procedures that I would like done, including fat removal from my large upper arms that had caused me great embarrassment for several years. Dr. Saber is an excellent surgeon who is incredibly kind and genuine. She truly understands the female body and the emotional aspect of body insecurities yet, she is transparent about what can and cannot be done and takes time to discuss realistic expectations and outcomes. My breast reconstruction revision surgery will take place in the New Year, but in the meantime, I have the most fabulous upper arms that I recently flaunted in a strapless dress (something I have not done in years). Dr Saber is truly one of a kind, and I still cannot believe how fortunate I am to have found her. I highly recommend Dr Saber.

    Linda DeCarlo November 29, 2023

    I don’t have enough wonderful words to describe Dr Saber and Marlene! I had a tummy tuck done this year and from start to finish the entire experience was amazing. Marlene is always so helpful and works so hard to make every detail a breeze for you. When I had my consultation with Dr Saber I was at a point of complete agony with my body. She instantly took that stress and frustration off my shoulders! As a woman not being heard by doctors for years I left that consultation with happy tears knowing I had finally found my Dr. It was a major surgery and I felt completely zen and at peace going in because she really does make you feel that safe. I didn’t think I would ever look the way I do now! She gave me the gift of having the body I kept fighting for. I will never stop recommending her.

    Monica Prusa October 9, 2023

    I saw Dr. Saber when I broke my wrist. I ended up having to have surgery. She did an excellent job and I am healing nicely. She was very professional, but was also very kind and compassionate. I would highly recommend her!!

    Sandy Schaupp September 13, 2022

    I LOVED DR SABER!!! There are a few reasons why I chose her. One was because she’s a female Doctor that was my goal who also did a good job (which I was able to confirm with all her before and after photos) and what sold me was my safety in mind. She made me feel like I was in the best hands ever along with Marlene who coordinated everything THANK YOU LADIES! Dr Saber helped me get back the body I have always desired. I had a lot of stomach fat from weight gain and I lost weight so a lot of my weight was in my front lower and upper abdomen. Now I have a super beautiful curvy body like an hourglass after a tummy tuck and lipo she did. She understood the assignment hahaha . I’m 32 years old no kids just wanted to enjoy my younger body looking and feeling beautiful and she really took good care of me. Even after hours I had an emergency due to my fault but she was there and got back to me very quickly and I’m very grateful. I also think her work says a lot because I stopped taking pain medication on the 3rd day after surgery and was fine with very minimal pain I was able to tolerate the healing process. Highly recommend going with her I just had a wonderful experience and would do it all over again if I had too. Maybe after I have kids. Thanks Dr Saber and team <3

    STEPHANIE d July 15, 2022

    Dr.Saber is by far one of the best plastic surgeons. I love how she takes her time to explain any procedure to the patients understanding. She always makes sure to answers any and all questions.From fillers to body contours she’s the one you want.

    Katherine Melara February 15, 2022

    Dr Saber is amazing! She is caring and very informative. I went in for fillers and she explained procedure step by step. I highly recommend her and look forward to future visits.

    Amanda Vazquez December 18, 2020

    Dr. Saber was friendly, knowledgeable and professional. She took time to listen, answer all my questions and was forthright in her recommendations. Her staff was friendly and helpful. I was very happy with the results and plan on going back. If you are looking for a first rate professional experience look no further she is the doctor for you!

    T R December 18, 2020

    Dr. Saber is one of a kind plastic surgeon with a heart of gold. She is a well verse plastic surgeon that puts her patient's needs before anything else. She genuinely cares about every single patient, and her work speaks for itself. I notice every post-operative result on her Instagram (@saberplasticsurgery) the patients have this glow that radiates through. I have been going to Dr. Saber for my Botox for the past 3 years, and love the results every time. I know who I will be going to for any future plastic surgery needs, and will confidently refer family and friends to Dr. Saber for any Botox, fillers, and plastic surgery consultations.

    Rudy Garcia December 16, 2020

    I have nothing but great things to say about Dr. Saber! I am so pleased with my results from a breast augmentation she performed on me back in late June! She answered all my questions and concerns before and after my surgery. She’s very easy to get in contact with and she’s so nice. She made feel so comfortable throughout the whole process. 100/10 Lover her work!!

    Amanda Villegas October 15, 2020

    Dr Saber is hands down the best surgeon! She took her time answering my questions and explained procedure in detail. After doing liposuction six months ago, I am extremely happy with my results and I appreciate her so much.

    Marlene Cosentino October 15, 2020

    Dr. Saber is so kind and thorough with her patients! She is an amazing doctor and genuinely cars about everyone she comes in contact with. I would recommend her to anyone for any hand surgery or cosmetic procedure.

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