Assisted reproductive technology outcomes in female-to-male transgender patients compared with cisgender patients: a new frontier in reproductive medicine

Transgender men who access assisted reproductive technology for fertility preservation or family building have excellent oocyte yield. Pregnancy outcome data are limited, but preliminary findings suggest a high rate of success.

Volume 112, Issue 5, Pages 858–865


Angela Leung, M.D., Denny Sakkas, Ph.D., Samuel Pang, M.D., Kim Thornton, M.D., Nina Resetkova, M.D., M.B.A.



To investigate assisted reproductive technology (ART) outcomes in a female-to-male transgender cohort and compare the results with those of a matched cisgender cohort.


Matched retrospective cohort study.


In vitro fertilization clinic.


Female-to-male transgender patients (n = 26) who sought care from 2010 to 2018. A cisgender cohort (n = 130) was matched during the same time period by age, body mass index, and antimüllerian hormone levels.


Not applicable.

Main Outcome Measure(s)

Cycle outcomes, including oocyte yield, number of mature oocytes, total gonadotropin dose, and peak E2 levels.


The mean number of oocytes retrieved in the transgender group was 19.9 ± 8.7 compared with 15.9 ± 9.6 in the cisgender group. Peak E2 levels were the same between the two groups. The total dose of gonadotropins used was higher in the transgender group compared with the cisgender group (3,892 IU vs. 2,599 IU). Of the 26 patients, 16 performed oocyte banking only. Seven couples had fresh or frozen transfers, with all achieving live births.


This is the first study of this size investigating ART outcomes in female-to-male transgender patients. The findings may serve to reassure transgender patients and their care providers that outcomes can be excellent even if testosterone therapy has already been initiated. Further investigation needs to be performed on the generalizability of these findings, and whether similar results can be achieved without stopping testosterone therapy.

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Go to the profile of M. Blake Evans
almost 3 years ago

A common question I have received from patients about to initiate testosterone therapy is whether or not their egg quality will be affected; especially a young teenager that has never even considered fertility preservation and may not want a family for 10+ years down the road. This study will be very helpful when counseling patients and discussing their options.