Successful oocyte cryopreservation using letrozole as an adjunct to stimulation in a transgender adolescent after GnRH agonist suppression

ObjectiveTo report a successful case of ovarian hyperstimulation and oocyte cryopreservation in transgender male adolescent after suppression with gonadotropin-releasing hormone (GnRH) agonist while using the aromatase inhibitor letrozole to maintain low serum estradiol.DesignCase report.SettingDivision Reproductive Endocrinology Infertility, Washington University St. Louis School Medicine, St Louis, Missouri.Patient(s)A 15-year-old Tanner II GnRH implant.Intervention(s)The implant was removed. The patient given (5 mg daily) undergoing stimulation an antagonist protocol. After retrieval, began taking testosterone.Main Outcome Measure(s)Successful minimal changes breast budding.Result(s)The patient's peak estradiol concentration 510 pg/mL. Twenty-two mature oocytes were cryopreserved. Small increases budding occurred between baseline time retrieval.Conclusion(s)We successfully used during stimulation. Maintaining minimize pubertal development possibly prevent gender dysphoria symptoms may make more desirable for adolescents. To estradiol. Case report. Division Missouri. A implant. testosterone. Successful budding. retrieval. We