Similar Fertilization Rates and Preimplantation Embryo Development Among Testosterone - Treated Transgender Men and Cisgender Women

Purpose:
To assess the effect of testosterone treatment on oocyte fertilization and preimplantation embryo development among transgender men who underwent fertility preservation.

Methods:
A retrospective study was undertaken in a university-affiliated tertiary hospital between 04/2016-11/2021. The source of embryos was divided into three groups: 210 embryos from 7 testosterone-exposed transgender men, 135 embryos from 10 cisgender women who cryopreserved embryos, and 276 embryos from 24 cisgender women who underwent fertility treatment. Statistical analyses compared ART data and outcomes between the group of transgender men and both groups of cisgender women. Morphokinetic and morphologic parameters were compared between the embryos derived from these three groups.

Results:
The transgender men (30.2±3.59 years of age) were significantly younger than the cisgender women who cryopreserved embryos (35.1±1.85 years; p = 0.005) and the cisgender women who underwent fertility treatment (33.8±3.23 years; p = 0.017). After adjusting for participant age, the fertilization rate was comparable between the transgender men and both cisgender women groups (p = 0.391 and 0.659). There were no significant differences between the transgender men and the cisgender women who preserved fertility in the number of cryopreserved embryos (7.2±5.09 and 3.5±2.66; p = 0.473) or the distribution of the embyros’ ages at which they were frozen (p = 0.576). All morphokinetic parameters that were evaluated by time-lapse imaging, as well as the morphologic characteristics, were comparable for the embryos of all three groups.

Conclusions:
Testosterone exposure among transgender men has no adverse impact upon fertilization rates or preimplantation embryo development and quality.