O-276 Fertility preservation and sperm quality in adolescent transgender patients prior to hormonal treatment

Abstract Study question This study investigated the take-up, hormonal profile and sperm quality in adolescents undergoing fertility preservation via different methods, prior to medical intervention for gender dysphoria. Summary answer Fertility surgical retrieval (SSR) or masturbation, is possible this group, however long-term data required check gamete health. What known already As increasing numbers of with dysphoria (GD) start gonadotrophin-releasing hormone agonists (GnRHa) delay puberty minimise psychological distress. However, uncertainty effects these medications highlights importance (FP) starting any treatment. design, size, duration Data wanting FP was prospectively maintained. A total 122 patients were referred FP, which 23 declined (19%). Participants/materials, setting, methods Young people counselled serum testosterone, FSH, LH recorded providing semen samples. Semen samples classified by concentration; normal >15mil/ml, oligospermia <15mil/ml, poor <1sperm/slide, azoospermia. Insufficient samples, unwillingness masturbate, meant SSR offered a stepwise manner using electroejaculation (EE), TESE mTESE. Main results role chance Most (n = 78, 64% - median age 16.7) able produce cryopreserving an average 6.6 straws. Sperm concentration 44% produced, 36% oligozoospermic, 9% concentration, 12% azoospermic. Mean blood showed: testosterone 12.32nmol/l, FSH 3.83 IU/L, 4.39 IU/L. 21 14.9. EE successful 4 patients, 9 underwent TESE, 8 mTESE Success rate 77%, 5.5 vials stored. parameters cohort possibly adequate ICSI. Hormone levels similar masturbation cohort: mean 11.7nmol/l, 3.4 3.5 3 used GnRHa pre-SSR. Following washout period, 1 patient remained azoospermic despite nmol/l. The other 2 had found abnormal morphology motility. largest UK transgender girls FP. showed that 67% within all patient’s >8nmol/l, saved. Limitations, reasons caution quantity on whether end up their gametes post factor consider study, as more evidence needed order display actual usage cryopreservation. Wider implications findings Masturbation often but alternatively, provides safe opportunity potentially have own biological children future. Trial registration number not applicable