Predicting successful sperm retrieval in transfeminine adolescents after testicular biopsy.
Adolescents
Sperm cryopreservation
Testicular biopsy
Transgender
Journal
Journal of assisted reproduction and genetics
ISSN: 1573-7330
Titre abrégé: J Assist Reprod Genet
Pays: Netherlands
ID NLM: 9206495
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
25
03
2021
accepted:
03
08
2021
pubmed:
24
8
2021
medline:
23
2
2022
entrez:
23
8
2021
Statut:
ppublish
Résumé
Increasing numbers of transgender adolescents are receiving gender-affirming treatments (GAT). Given GAT can impair reproductive function, clinical guidelines advise prior counselling regarding fertility preservation (FP). For transgender adults assigned male at birth, FP is usually achieved via a masturbatory sample and sperm cryopreservation. This is less straightforward in transgender adolescents, since they may not be developmentally ready to masturbate and/or masturbation may cause unacceptable gender dysphoria. Testicular biopsy represents an alternative method for sperm retrieval in these adolescents, but for those in early/mid puberty, it is difficult to predict whether sperm will be found. The purpose of this study was therefore to identify factors that predict successful sperm retrieval for cryopreservation via testicular biopsy. A retrospective cohort study was undertaken at a tertiary-referral pediatric gender service. Subjects were included if they'd received a testicular biopsy in association with the commencement of GAT between 2010 and 2019. The primary outcome measure was successful sperm retrieval, and potential predictors included age, testicular volume and serum testosterone, LH and FSH levels. Of 25 subjects who received a biopsy prior to starting any GAT, 17 had successful sperm retrieval. While age, testosterone, LH and FSH levels showed minimal differences, testicular volume was significantly higher in those with successful sperm retrieval, and a threshold of ≥ 10 mL showed 92% sensitivity and 71% specificity in predicting successful retrieval. An additional 6 patients received a biopsy after starting puberty suppression and before commencement of oestrogen, and one of these individuals had sperm successfully retrieved despite > 2 years of regular puberty suppression. These findings suggest that testicular volume is most useful in predicting successful sperm retrieval following testicular biopsy in transgender adolescents and are likely to be of relevance to other young people undertaking FP, including those with cancer.
Identifiants
pubmed: 34424432
doi: 10.1007/s10815-021-02293-z
pii: 10.1007/s10815-021-02293-z
pmc: PMC8581091
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2735-2743Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
JAMA Netw Open. 2020 Jul 1;3(7):e2011161
pubmed: 32721030
J Adolesc Health. 2019 May;64(5):589-593
pubmed: 30691936
Helv Paediatr Acta. 1974 Apr;29(1):61-72
pubmed: 4838166
Fertil Steril. 2014 Jul;102(1):199-205.e1
pubmed: 24780076
Arch Dis Child. 1990 Nov;65(11):1205-7
pubmed: 2248529
Transl Androl Urol. 2014 Mar;3(1):2-8
pubmed: 26813354
Med Pediatr Oncol. 1996 Jan;26(1):20-7
pubmed: 7494508
J Sex Med. 2018 May;15(5):757-767
pubmed: 29699760
Int J Androl. 1983 Apr;6(2):143-56
pubmed: 6862671
Gynecol Endocrinol. 2014;30(12):868-71
pubmed: 25254620
Med J Aust. 2018 Aug 6;209(3):132-136
pubmed: 29902964
Reprod Health. 2018 Oct 25;15(1):181
pubmed: 30359260
Histopathology. 1988 Apr;12(4):451-4
pubmed: 3371900
Hum Reprod. 2002 Dec;17(12):3157-61
pubmed: 12456617
Hum Reprod. 2015 Nov;30(11):2463-75
pubmed: 26358785
JAMA Pediatr. 2020 Sep 1;174(9):890-891
pubmed: 32282014
Hum Reprod. 2010 Aug;25(8):2031-8
pubmed: 20570975
Cult Health Sex. 2015;17(9):1119-31
pubmed: 26109170
Eur J Endocrinol. 2004 Dec;151(6):747-57
pubmed: 15588242
J Adolesc Health. 2016 Mar;58(3):369-71
pubmed: 26903434
J Urol. 2012 Aug;188(2):594-7
pubmed: 22704091
J Adolesc Health. 2020 Jun;66(6):658-665
pubmed: 32115323
J Clin Endocrinol Metab. 1986 Mar;62(3):532-5
pubmed: 3944237
J Clin Endocrinol Metab. 2012 Dec;97(12):4341-51
pubmed: 23038680
Urology. 2019 Feb;124:136-141
pubmed: 30312673
J Sex Med. 2016 Jul;13(7):1125-32
pubmed: 27318023
Fertil Steril. 2008 Oct;90(4):1119-25
pubmed: 17905241
J Clin Endocrinol Metab. 1993 Jan;76(1):26-31
pubmed: 8421096
N Engl J Med. 1981 Sep 17;305(12):663-7
pubmed: 6267464
Hum Reprod. 2017 Feb;32(2):383-390
pubmed: 27999119
J Clin Endocrinol Metab. 2009 Sep;94(9):3132-54
pubmed: 19509099
Ann Acad Med Singap. 1987 Apr;16(2):347-8
pubmed: 3688813
J Adolesc Health. 2017 Jul;61(1):40-44
pubmed: 28161526
Hum Reprod Update. 2001 Jul-Aug;7(4):378-83
pubmed: 11476350
J Sex Med. 2015 Nov;12(11):2190-200
pubmed: 26559385
Sci Rep. 2017 Jan 03;7:39931
pubmed: 28045098
Clin Endocrinol (Oxf). 2017 Sep;87(3):279-285
pubmed: 28504866
Am J Hum Biol. 2000 Sep;12(5):577-587
pubmed: 11534049
J Androl. 2004 Jul-Aug;25(4):586-92
pubmed: 15223847
Fertil Steril. 1992 Sep;58(3):603-8
pubmed: 1387850
Arch Dis Child. 2019 Aug;104(8):739-744
pubmed: 30894340
Hum Reprod. 2012 Feb;27(2):483-7
pubmed: 22128292
Cell Tissue Res. 1988 Jan;251(1):31-43
pubmed: 3342442
J Pediatr. 1995 Jul;127(1):100-2
pubmed: 7608791