Ovarian tissue cryopreservation in female-to-male transgender people: insights into ovarian histology and physiology after prolonged androgen treatment

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 158.18 +/- 26.57 weeks). In the cortex, most follicles were primordial 168.52% total follicle count) compared with 20.26% intermediate and 10.74% primary follicles. Few secondary follicles 10.46%I and a single antral follicle were found in the sections analysed. In total, 1313 COC were retrieved from the medulla of 35 patients 137.51 +/- 33.58 COC per patient). Anti-Muller an hormone serum levels were significantly correlated with number of COC (R-5 0.787, 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. (C) 2017 Reproductive Healthcare Ltd. Published by Elsevierd. All rights reserved.