Ovary function is preserved in transgender men even after 1 year of testosterone therapy, according to an abstract presented at ENDO 2019: The Endocrine Society Annual Meeting, held March 23 to 26 in New Orleans, Louisiana.1

Even though transgender men have carried out successful pregnancies, the long-term effects of testosterone therapy on fertility remain unknown. As such, in this prospective, open-label study, researchers recruited 52 transgender men receiving testosterone therapy to study the markers of ovarian reserve. Data were collected at baseline and 12 months after treatment initiation.

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Of the 52 participants, 32% were in a stable relationship, 50% were unsure about future parenthood, and 7% had already undergone fertility preservation procedures. The average age was 23.4 ± 6.1 years. Complete data were available for 32 participants.

Compared with baseline, testosterone levels increased (0.84 vs 7 nmol/L; P <.0001) and estradiol levels decreased (90.8 vs 55.4 pmol/L; P =.0013) at 12 months of treatment. There was a concomitant decrease in luteinizing hormone (7.56 vs 3.8 mIU/mL; P =.0012), but not follicle-stimulating hormone (5.1 vs 4 mIU/mL; P =.07) levels.

Despite the increase in testosterone levels and decrease in estradiol levels, however, anti-Müllerian hormone levels decreased only slightly, going from 5.65 ng/mL at baseline to 4.89 ng/mL at 12 months (P =.036). This likely indicates “well-preserved ovarian reserve,” noted the researchers, which was further highlighted by the fact that antral follicular count and endometrial thickness also remained unchanged.

“Although there is a need to investigate the effects of testosterone on further fertility parameters such as quality of oocytes and in vitro fertilized embryos, these results are a further step toward providing transgender people basic rights such as reproduction,” said Yona Greenman, MD, the study’s lead investigator, in a press release.2

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References

1. Yaish I, Malinger G, Foad A, et al. Evidence for preserved ovarian reserve in transgender men receiving testosterone therapy: anti-Müllerian hormone serum levels decrease modestly after one year of treatment. Presented at: ENDO 2019; March 23-26, 2019; New Orleans, LA. Abstract OR11-3.

2. Ovary function is preserved in transgender men at one year of testosterone therapy [press release]. Washington, DC: Endocrine Society; March 23, 2019. Accessed March 23, 2019.