title: Ovarian tissue cryopreservation in female-to-male transgender people: insights into ovarian histology and physiology after prolonged androgen treatment.
abstract: Female-to-male transgender people (trans men) are faced with the risk of losing their reproductive potential owing to gender-affirming hormone treatment and genital reconstructive surgery. This observational, prospective cohort study investigates the effect of prolonged androgen therapy on their ovarian histology and fertility preservation perspectives. Hormone serum levels, ovarian histology and cumulus-oocyte complexes (COC) of 40 trans men were analysed at the moment of hysterectomy with bilateral oophorectomy in the context of genital reconstructive surgery after testosterone treatment (58.18 ± 26.57 weeks). In the cortex, most follicles were primordial (68.52% total follicle count) compared with 20.26% intermediate and 10.74%primary follicles. Few secondary follicles (0.46%) and a single antral follicle were found in the sections analysed. In total, 1313 COC were retrieved from the medulla of 35 patients (37.51 ± 33.58 COC per patient). Anti-Müllerian hormone serum levels were significantly correlated with number of COC (Rs0.787, P < 0.001). After 48 h in-vitro maturation, 34.30% metaphase II oocytes were obtained, with 87.10% having a normal spindle structure. In conclusion, the cortical follicle distribution in trans men, after more than a year of testosterone treatment, seems to be surprisingly normal. This work confirms the presence and in-vitro maturation potential of cumulus-oocyte complexes.
authors.affiliation: Division of Reproductive Medicine, Department of Gynaecology, Ghent University Hospital, 9000 Ghent, Belgium. Electronic address: chloe.deroo@ugent.be.
authors.forename: Chloë
authors.initials: C
authors.lastname: De Roo
authors.affiliation: Division of Reproductive Medicine, Department of Gynaecology, Ghent University Hospital, 9000 Ghent, Belgium.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Lierman
authors.affiliation: Division of Reproductive Medicine, Department of Gynaecology, Ghent University Hospital, 9000 Ghent, Belgium.
authors.forename: Kelly
authors.initials: K
authors.lastname: Tilleman
authors.affiliation: Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium; Centre for Nano-and Bio Photonics (NB-Photonics), Ghent University, 9000 Ghent, Belgium.
authors.forename: Karen
authors.initials: K
authors.lastname: Peynshaert
authors.affiliation: Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium.
authors.forename: Kevin
authors.initials: K
authors.lastname: Braeckmans
authors.affiliation: Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, VU medical centre (VUmc), 1007 MB Amsterdam, The Netherlands.
authors.forename: Mirte
authors.initials: M
authors.lastname: Caanen
authors.affiliation: Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, VU medical centre (VUmc), 1007 MB Amsterdam, The Netherlands.
authors.forename: Cornelius B
authors.initials: CB
authors.lastname: Lambalk
authors.affiliation: Division of Reproductive Medicine, Department of Gynaecology, Ghent University Hospital, 9000 Ghent, Belgium.
authors.forename: Steven
authors.initials: S
authors.lastname: Weyers
authors.affiliation: Department of Endocrinology and Centre for Sexology and Gender, Ghent University Hospital, 9000 Ghent, Belgium.
authors.forename: Guy
authors.initials: G
authors.lastname: T'Sjoen
authors.affiliation: Department of Basic Medical Science, Faculty of Medicine and Health Science, Ghent University, 9000 Ghent, Belgium.
authors.forename: Ria
authors.initials: R
authors.lastname: Cornelissen
authors.affiliation: Division of Reproductive Medicine, Department of Gynaecology, Ghent University Hospital, 9000 Ghent, Belgium.
authors.forename: Petra
authors.initials: P
authors.lastname: De Sutter
mesh_terms: D000293:Adolescent; D000328:Adult; D000728:Androgens / Q000494:pharmacology*; D015925:Cryopreservation; D005260:Female; D006728:Hormones / Q000097:blood; D006801:Humans; D059471:In Vitro Oocyte Maturation Techniques; D008297:Male; D010053:Ovary / Q000033:anatomy & histology / Q000187:drug effects*; D011446:Prospective Studies; D013739:Testosterone / Q000494:pharmacology*; D063106:Transgender Persons; D055815:Young Adult
chemical_list: D000728:Androgens; D006728:Hormones; D013739:Testosterone
keywords: Anti-Müllerian hormone; Cumulus-oocyte complex; Fertility preservation; In vitro maturation; Ovarian tissue; Transgender