{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T04:27:12Z","timestamp":1743740832341,"version":"3.40.3"},"reference-count":54,"publisher":"Georg Thieme Verlag KG","issue":"02","funder":[{"name":"Innovative Medizinische Forschung","award":["Kennzeichen SC 212412"],"award-info":[{"award-number":["Kennzeichen SC 212412"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aktuelle Urol"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Nach aktuellen Leitlinien muss bei Behandlungssuchenden mit Geschlechtsinkongruenz eine\n      ad\u00e4quate Aufkl\u00e4rung \u00fcber die verschiedenen M\u00f6glichkeiten einer Fertilit\u00e4tsprotektion durch\n      medizinisches Fachpersonal stattfinden. Durch die geschlechtsangleichende Hormontherapie bei\n      Behandlungssuchenden mit m\u00e4nnlichem Zuweisungsgeschlecht kommt es zu einer Reduktion von LH,\n      FSH und Testosteron und damit einhergehend zu einer Regression der Spermatogenese (bis hin zum\n      vollst\u00e4ndigen Ausbleiben) und einer konsekutiven Hodenatrophie. Behandlungssuchende, die mit\n      der geschlechtsangleichenden Hormontherapie nach einer durchlebten m\u00e4nnlichen Pubert\u00e4t\n      beginnen, k\u00f6nnen eine Ejakulatprobe abgeben, um Spermien zu kryokonservieren. Falls im\n      Ejakulat unter geschlechtsangleichender Hormontherapie keine Spermien zu finden sind oder das\n      Abgeben von Ejakulat nicht mehr m\u00f6glich oder psychisch zu belastend ist, sollte eine\n      (mikrochirurgische) testikul\u00e4re Spermienextraktion ([m]TESE), angeboten werden. Eine\n      Elektroejakulation unter Narkose ist eher selten zielf\u00fchrend, da die Samenzellbildung unter\n      Hormonbehandlung gest\u00f6rt. Aus diesem Grund ist auch eine mikrochirurgische epididymale\n      Spermienaspirtation (MESA) nicht zielf\u00fchrend. Wird bei Jugendlichen mit Geschlechtsinkongruenz\n      die Pubert\u00e4tsblockade und\/oder die geschlechtsangleichende Hormontherapie bereits in einem\n      fr\u00fchen Stadium der Pubert\u00e4t (ab Tanner-Stadium 2 m\u00f6glich) begonnen, wird eine Ausreifung\n      spermatogonialer Stammzellen zu reifen Spermien verhindert. Die Pubert\u00e4tsblockade mit GnRH\n      f\u00fchrt zu einer Reduktion von LH und FSH in der Hirnanhangsdr\u00fcse. Konsekutiv finden keine\n      Testosteronproduktion in den Leydig-Zellen und auch keine Stimulation der Spermatogenese im\n      Hoden statt. In diesen F\u00e4llen ist die Kryokonservierung von spermatogonialen Stammzellen, wie\n      sie in einigen L\u00e4ndern f\u00fcr peripubert\u00e4re Patienten vor einer notwendigen keimzellsch\u00e4digenden\n      Therapie angeboten wird, m\u00f6glich. In Deutschland existiert ein entsprechendes Netzwerk\n      (Androprotect), das bereits 2012 in M\u00fcnster gegr\u00fcndet wurde. Dieses Vorgehen wird in\n      Deutschland \u00fcber Androprotect auch f\u00fcr jugendliche Behandlungssuchende mit\n      Geschlechtsinkongruenz angeboten. Das Vorgehen gilt als experimentell, da es derzeit noch\n      keine etablierte Therapie f\u00fcr die sp\u00e4tere Refertilisierung der betroffenen Erwachsenen gibt,\n      wenngleich mehrere Verfahren der In-vitro-Spermienreifung und Gewebetransplantation in der\n      Entwicklung sind. Bei der Betreuung von Menschen mit Geschlechtsinkongruenz sollten im\n      interdisziplin\u00e4ren Behandlungsteam eine individuelle Beratung durch erfahrenes Fachpersonal\n      stattfinden und im Sinne einer partizipativen Entscheidungsfindung (informed consent) individuelle Behandlungsans\u00e4tze angeboten werden, um f\u00fcr jeden\n      Behandlungssuchenden den richtigen Weg zur Entscheidung f\u00fcr oder gegen eine\n      Fertilit\u00e4tsprotektion zu finden.<\/jats:p>","DOI":"10.1055\/a-2490-4059","type":"journal-article","created":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T00:20:07Z","timestamp":1738801207000},"page":"150-157","source":"Crossref","is-referenced-by-count":0,"title":["Fertilit\u00e4tsprotektion bei Personen mit Geschlechtsinkongruenz und m\u00e4nnlichem Zuweisungsgeschlecht"],"prefix":"10.1055","volume":"56","author":[{"given":"Florian Josef","family":"Schneider","sequence":"additional","affiliation":[{"name":"Center for Reproductive Medicine and Andrology, Department of Clinical and Surgical Andrology, University Hospital M\u00fcnster, Munster, Germany"},{"name":"University Hospital M\u00fcnster, Center of Transgender Health, M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bettina","family":"Scheffer","sequence":"additional","affiliation":[{"name":"Center for Reproductive Medicine and Andrology, Department of Clinical and Surgical Andrology, University Hospital M\u00fcnster, Munster, Germany"},{"name":"University Hospital M\u00fcnster, Center of Transgender Health, M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabine","family":"Kliesch","sequence":"additional","affiliation":[{"name":"Center for Reproductive Medicine and Andrology, Department of Clinical and Surgical Andrology, University Hospital M\u00fcnster, Munster, Germany"},{"name":"University Hospital M\u00fcnster, Center of Transgender Health, M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jann-Frederik","family":"Cremers","sequence":"additional","affiliation":[{"name":"Center for Reproductive Medicine and Andrology, Department of Clinical and Surgical Andrology, University Hospital M\u00fcnster, Munster, Germany"},{"name":"University Hospital M\u00fcnster, Center of Transgender Health, M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,2,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"3869","DOI":"10.1210\/jc.2017-01658","article-title":"Endocrine Treatment of Gender-Dysphoric\/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline","volume":"102","author":"WC Hembree","year":"2017","journal-title":"J Clin Endocrinol Metab"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"725","DOI":"10.3238\/arztebl.2020.0725","article-title":"Hormonal Gender Reassignment 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