Family Building in Transgender Patients: Modern Strategies with Assisted Reproductive Technology Treatment

Abstract

Purpose: Transgender and gender diverse (TGD) individuals continue to face adversity, stigma, and inequality, especially in health care. This study aimed to characterize the experience of TGD people and partners of TGD people with regard to fertility treatment.

Methods: All TGD patients presenting to a single academic center between 2013 and 2021 were included. Baseline demographics collected included patient age, body mass index, anti-Mullerian hormone, basal antral follicle count, history of gender-affirming surgery, and/or gender-affirming hormone therapy. Outcomes included total patients who progressed to treatment, cycle type(s), and clinical outcomes.

Results: In total, 82 patients who identified as TGD or had a partner who identified as TGD presented to care seeking fertility treatment. Of the 141 planned cycles, 106 (75.2%) progressed to treatment. Of the 15 in vitro fertilization (IVF) and co-IVF cycles, 12 achieved live birth. Of the 76 intrauterine inseminations 7 patients were discharged with ongoing pregnancies and one achieved live birth.

Conclusion: These findings reaffirm that TGD individuals utilize the entire array of fertility services. With recent advances in access to care and modern medicine, assisted reproductive technology treatment has the power to support TGD patients in building contemporary family structures.

Keywords: assisted reproductive technology; barriers; equality; insurance; transgender.

FIG. 1.

IVF and Co-IVF clinical outcomes: Of the pooled 15 IVF and co-IVF cycles that progressed to treatment, 12 achieved live birth and 3 did not achieve clinical pregnancy. IVF, in vitro fertilization.

FIG. 2.

IUI clinical outcomes: Of the 76 IUI cycles that progressed to treatment, 1 achieved live birth and 7 achieved ongoing pregnancies, and were discharged to their obstetrician. Sixty-eight IUI cycles did not achieve clinical pregnancy. IUI, intrauterine insemination.