{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T03:33:23Z","timestamp":1791516803418,"version":"4.3.4"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Reproductive Scientist Development"},{"DOI":"10.13039\/100002603","name":"American Society for Reproductive Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002603","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"Abstract<\/jats:title>\n \n STUDY QUESTION<\/jats:title>\n Do transgender and gender diverse patients with prior testosterone gender affirming hormone therapy (T-GAHT) have oocyte cryopreservation and IVF outcomes that differ from those without prior T-GAHT?<\/jats:p>\n <\/jats:sec>\n \n SUMMARY ANSWER<\/jats:title>\n Prior T-GAHT was associated with a decrease in the total number of blastocysts after adjusting for age, but not with a difference in the number of mature oocytes.<\/jats:p>\n <\/jats:sec>\n \n WHAT IS KNOWN ALREADY<\/jats:title>\n Many TGD people pursue oocyte cryopreservation or IVF after previously initiating T-GAHT for fertility preservation and\/or a partner-carried pregnancy; however, data regarding embryo outcomes are scarce. Retrospective cohort studies suggest high mature oocyte yields in oocyte cryopreservation following T-GAHT, but it is unknown whether embryos from patients with prior T-GAHT have a normal capacity to fertilize, cleave, and form blastocysts.<\/jats:p>\n <\/jats:sec>\n \n STUDY DESIGN, SIZE, DURATION<\/jats:title>\n This was a retrospective observational cohort study of 46 ovarian stimulation cycles initiated for TGD patients assigned female at birth with and without prior T-GAHT from January 2013 to March 2024.<\/jats:p>\n <\/jats:sec>\n \n PARTICIPANTS\/MATERIALS, SETTING, METHODS<\/jats:title>\n This study included 36 TGD patients assigned female at birth, 25 undergoing IVF and 11 undergoing oocyte cryopreservation. Prior T-GAHT timing, duration, and discontinuation, as well as stimulation cycle characteristics and outcomes collected from the electronic health record retrospectively. Cycles outcomes of TGD people with prior T-GAHT were compared to those without prior T-GAHT. The first completed cycle was used for statistical analysis, with the first initiated cycle (intention to treat) and all cycles as sensitivity analyses. The primary outcome was the number of mature oocytes retrieved for all patients and the total number of blastocysts for patients undergoing IVF. Our secondary outcomes were maturity rate, number of top-quality blastocysts (AB or better), and cumulative live birth rate. A sub-analysis of subjects with prior T-GAHT was performed assessing discontinuation timing and IVF outcomes.<\/jats:p>\n <\/jats:sec>\n \n MAIN RESULTS AND THE ROLE OF CHANCE<\/jats:title>\n Of the 36 TGD patients included, 14 subjects (20 cycles) had prior T-GAHT, 22 patients (26 cycles) had no prior T-GAHT. Accounting for multiple cycles in 10 subjects, a total of 17 IVF and 3 oocyte cryopreservation cycles were initiated in the prior T-GAHT cohort, and 18 IVF and 8 oocyte cryopreservation cycles in the no T-GAHT cohort. After adjusting for age, in the first cycle, prior T-GAHT was associated with a decrease in the total number of blastocysts (coefficient \u22120.62, 95% CI: \u22120.95, \u22120.30) and number of top-quality blastocysts (coefficient \u22121.09, 95% CI: \u22121.68, \u22120.51) but was not associated with a difference in the number of mature oocytes or maturity. Modeling using the first initiated cycle and including all 46 cycles demonstrated the same results. The first cycle cumulative live birth rate was 60% in the prior T-GAHT cohort and 87.5% in those without T-GAHT (P\u2009=\u20090.20). In patients with prior T-GAHT pursuing IVF for transfer, 80% were ultimately able to achieve a live birth. In the first completed IVF cycle for patients with prior T-GAHT, T-GAHT cessation of &lt;6\u2009months was associated with fewer top-quality blastocysts (P\u2009=\u20090.01) and fewer BB or better quality blastocysts (P\u2009=\u20090.049).<\/jats:p>\n <\/jats:sec>\n \n LIMITATIONS, REASONS FOR CAUTION<\/jats:title>\n This study is primarily limited by its small sample size and retrospective study design, introducing risk of selection bias and sampling error and limiting our ability to adjust for multiple factors. Limited specificity and reliance on recall in T-GAHT initiation and discontinuation timing is a limitation in this study as it is a recurrent limitation in retrospective studies of TGD patients.<\/jats:p>\n <\/jats:sec>\n \n WIDER IMPLICATIONS OF THE FINDINGS<\/jats:title>\n Prior T-GAHT was not associated with differences in mature oocyte number, consistent with prior literature. However, we found that prior T-GAHT and shorter discontinuation were associated with poorer embryo outcomes. This may suggest that patients undergoing oocyte cryopreservation after only brief T-GAHT discontinuation may need to cryopreserve a greater number of oocytes to yield high-quality embryos. Overall, these results add to the growing body of reassuring fertility outcomes for TGD patients with prior T-GAHT, as the majority of these patients pursuing IVF for transfer were able to achieve a live birth.<\/jats:p>\n <\/jats:sec>\n \n STUDY FUNDING\/COMPETING INTEREST(S)<\/jats:title>\n Dr Rubin\u2019s time is partially supported through the Reproductive Scientist Development Program, with full funds supplied by the American Society for Reproductive Medicine. The authors have no competing interest to disclose.<\/jats:p>\n <\/jats:sec>\n \n TRIAL REGISTRATION NUMBER<\/jats:title>\n N\/A.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/humrep\/deag003","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T12:40:45Z","timestamp":1767876045000},"page":"371-380","source":"Crossref","is-referenced-by-count":1,"title":["In vitro<\/i>\n fertilization outcomes in transgender individuals with prior testosterone therapy"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7567-0151","authenticated-orcid":false,"given":"E S","family":"Rubin","sequence":"first","affiliation":[{"name":"Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Oregon Health and Science University , Portland, OR,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Kornfield","sequence":"additional","affiliation":[{"name":"Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Oregon Health and Science University , Portland, OR,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Palmor","sequence":"additional","affiliation":[{"name":"Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Oregon Health and Science University , Portland, OR,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M B","family":"Luck","sequence":"additional","affiliation":[{"name":"Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Oregon Health and Science University , Portland, OR,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Garg","sequence":"additional","affiliation":[{"name":"Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Oregon Health and Science University , Portland, OR,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Oregon Health and Science University , Portland, OR,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"O\u2019Leary","sequence":"additional","affiliation":[{"name":"Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Oregon Health and Science University , Portland, OR,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Krieg","sequence":"additional","affiliation":[{"name":"Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Oregon Health and Science University , Portland, OR,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Amato","sequence":"additional","affiliation":[{"name":"Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Oregon Health and Science University , Portland, OR,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,27]]},"reference":[{"key":"2026030500513146900_deag003-B1","doi-asserted-by":"crossref","first-page":"2155","DOI":"10.1007\/s10815-019-01558-y","article-title":"Ovarian stimulation for fertility preservation or family building in a cohort of transgender men","volume":"36","author":"Adeleye","year":"2019","journal-title":"J Assist Reprod Genet"},{"key":"2026030500513146900_deag003-B2","first-page":"55","article-title":"Timing of testosterone discontinuation and assisted reproductive technology outcomes in transgender patients: a cohort study","volume":"4","author":"Albar","year":"2023","journal-title":"F S Rep"},{"key":"2026030500513146900_deag003-B3","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1016\/j.rbmo.2022.01.003","article-title":"Why fertility preservation rates of transgender men are much lower than those of transgender women","volume":"44","author":"Alpern","year":"2022","journal-title":"Reprod Biomed Online"},{"key":"2026030500513146900_deag003-B4","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1016\/j.rbmo.2020.05.003","article-title":"Fertility preservation rates among transgender women compared with transgender men receiving comprehensive fertility counselling","volume":"41","author":"Amir","year":"2020","journal-title":"Reprod Biomed Online"},{"key":"2026030500513146900_deag003-B5","doi-asserted-by":"crossref","first-page":"2463","DOI":"10.1007\/s10815-020-01902-7","article-title":"Ovarian stimulation outcomes among transgender men compared with fertile cisgender women","volume":"37","author":"Amir","year":"2020","journal-title":"J Assist Reprod Genet"},{"key":"2026030500513146900_deag003-B6","doi-asserted-by":"crossref","first-page":"101440","DOI":"10.1016\/j.xcrm.2024.101440","article-title":"One-third of amenorrheic transmasculine people on testosterone ovulate","volume":"5","author":"Asseler","year":"2024","journal-title":"Cell Rep Med"},{"key":"2026030500513146900_deag003-B7","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.rbmo.2023.03.007","article-title":"Outcomes of oocyte vitrification in trans masculine individuals","volume":"47","author":"Asseler","year":"2023","journal-title":"Reprod Biomed Online"},{"key":"2026030500513146900_deag003-B8","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1016\/j.jsxm.2018.03.083","article-title":"Desire to have children among transgender people in Germany: a cross-sectional multi-center study","volume":"15","author":"Auer","year":"2018","journal-title":"J Sex Med"},{"key":"2026030500513146900_deag003-B9","doi-asserted-by":"crossref","first-page":"873508","DOI":"10.3389\/fendo.2022.873508","article-title":"Fertility preservation for adolescent and young adult transmen: a case series and insights on oocyte cryopreservation","volume":"13","author":"Barrett","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"2026030500513146900_deag003-B10","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1136\/bmj.310.6973.170","article-title":"Multiple significance tests: the Bonferroni method","volume":"310","author":"Bland","year":"1995","journal-title":"BMJ"},{"key":"2026030500513146900_deag003-B11","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.rbmo.2021.05.010","article-title":"Endocrinological and ovarian histological investigations in assigned female at birth transgender people undergoing testosterone therapy","volume":"43","author":"Borr\u00e1s","year":"2021","journal-title":"Reprod Biomed Online"},{"key":"2026030500513146900_deag003-B12","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1080\/15532739.2017.1352554","article-title":"Care of the transgender or gender-nonconforming patient undergoing in vitro fertilization","volume":"18","author":"Broughton","year":"2017","journal-title":"Int J Transgend"},{"key":"2026030500513146900_deag003-B13","doi-asserted-by":"crossref","first-page":"2057","DOI":"10.1007\/s10815-018-1292-4","article-title":"Oocyte cryopreservation among transmasculine youth: a case series","volume":"35","author":"Chen","year":"2018","journal-title":"J Assist Reprod Genet"},{"key":"2026030500513146900_deag003-B14","first-page":"43","article-title":"Fertility preservation in a transgender man without prolonged discontinuation of testosterone: a case report and literature review","volume":"1","author":"Cho","year":"2020","journal-title":"F S Rep"},{"key":"2026030500513146900_deag003-B15","volume-title":"Estimated Number of US LGBT Adults in Large Metropolitan Statistical Areas","author":"Conron","year":"2020"},{"key":"2026030500513146900_deag003-B16","doi-asserted-by":"crossref","first-page":"e0265043","DOI":"10.1371\/journal.pone.0265043","article-title":"Fertility preservation in transgender and non-binary adolescents and young adults","volume":"17","author":"Cooper","year":"2022","journal-title":"PLoS One"},{"key":"2026030500513146900_deag003-B17","doi-asserted-by":"crossref","first-page":"e121","DOI":"10.1097\/AOG.0000000000005749","article-title":"Oocyte cryopreservation in transgender and gender-diverse individuals with or without prior testosterone use","volume":"144","author":"Cromack","year":"2024","journal-title":"Obstet Gynecol"},{"key":"2026030500513146900_deag003-B18","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1080\/15532739.2019.1692750","article-title":"Parental desire and fertility preservation in assigned male at birth transgender people living in Belgium","volume":"21","author":"Defreyne","year":"2020","journal-title":"Int J Transgend Health"},{"key":"2026030500513146900_deag003-B19","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.fertnstert.2019.09.002","article-title":"Parental desire and fertility preservation in assigned female at birth transgender people living in Belgium","volume":"113","author":"Defreyne","year":"2020","journal-title":"Fertil Steril"},{"key":"2026030500513146900_deag003-B20","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1016\/j.fertnstert.2013.11.004","article-title":"The nature of aneuploidy with increasing age of the female partner: a review of 15,169 consecutive trophectoderm biopsies evaluated with comprehensive chromosomal screening","volume":"101","author":"Franasiak","year":"2014","journal-title":"Fertil Steril"},{"key":"2026030500513146900_deag003-B21","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1007\/s11606-021-06791-9","article-title":"Initial clinical needs among transgender and non-binary individuals in a large, urban gender health program","volume":"37","author":"Gaither","year":"2022","journal-title":"J Gen Intern Med"},{"key":"2026030500513146900_deag003-B22","first-page":"249","article-title":"Oocyte cryopreservation in a transgender man on long-term testosterone therapy: a case report","volume":"2","author":"Gale","year":"2021","journal-title":"F S Rep"},{"key":"2026030500513146900_deag003-B23","first-page":"367","article-title":"Fertility treatment outcomes in transgender men with a history of testosterone therapy","volume":"4","author":"Ghofranian","year":"2023","journal-title":"F S Rep"},{"key":"2026030500513146900_deag003-B24","first-page":"19","article-title":"Successful in vitro fertilization in a cisgender female carrier using oocytes retrieved from a transgender man maintained on testosterone","volume":"8","author":"Greenwald","year":"2022","journal-title":"AACE Clin Case Rep"},{"key":"2026030500513146900_deag003-B25","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.1016\/j.jsxm.2020.05.029","article-title":"Ovarian histopathology in transmasculine persons on testosterone: a multicenter case series","volume":"17","author":"Grimstad","year":"2020","journal-title":"J Sex Med"},{"key":"2026030500513146900_deag003-B26","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1093\/humrep\/des385","article-title":"Excessive androgen exposure in female-to-male transsexual persons of reproductive age induces hyperplasia of the ovarian cortex and stroma but not polycystic ovary morphology","volume":"28","author":"Ikeda","year":"2013","journal-title":"Hum Reprod"},{"key":"2026030500513146900_deag003-B27","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1016\/j.jadohealth.2019.12.004","article-title":"Fertility preservation for adolescent transgender male patients: a case series","volume":"66","author":"Insogna","year":"2020","journal-title":"J Adolesc Health"},{"key":"2026030500513146900_deag003-B28","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/j.rbmo.2022.04.016","article-title":"Similar fertilization rates and preimplantation embryo development among testosterone-treated transgender men and cisgender women","volume":"45","author":"Israeli","year":"2022","journal-title":"Reprod Biomed Online"},{"key":"2026030500513146900_deag003-B29","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1016\/j.fertnstert.2019.07.014","article-title":"Assisted reproductive technology outcomes in female-to-male transgender patients compared with cisgender patients: a new frontier in reproductive medicine","volume":"112","author":"Leung","year":"2019","journal-title":"Fertil Steril"},{"key":"2026030500513146900_deag003-B30","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1016\/j.fertnstert.2021.02.025","article-title":"Successful oocyte cryopreservation using letrozole as an adjunct to stimulation in a transgender adolescent after GnRH agonist suppression","volume":"116","author":"Martin","year":"2021","journal-title":"Fertil Steril"},{"key":"2026030500513146900_deag003-B31","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1080\/26895269.2020.1864560","article-title":"Reproductive desires in transgender and gender diverse adults: a cross-sectional study in Thailand","volume":"23","author":"Mattawanon","year":"2022","journal-title":"Int J Transgend Health"},{"key":"2026030500513146900_deag003-B32","doi-asserted-by":"crossref","first-page":"hoac008","DOI":"10.1093\/hropen\/hoac008","article-title":"Fertility preservation and fertility treatment in transgender adolescents and adults in a Swedish region, 2013\u20132018","volume":"2022","author":"Mattelin","year":"2022","journal-title":"Hum Reprod Open"},{"key":"2026030500513146900_deag003-B33","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1097\/AOG.0000000000002036","article-title":"Pregnancy outcomes after fertility preservation in transgender men","volume":"129","author":"Maxwell","year":"2017","journal-title":"Obstet Gynecol"},{"key":"2026030500513146900_deag003-B34","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1089\/lgbt.2021.0148","article-title":"Assessing fertility intentions in patients presenting for gender-affirming surgery","volume":"9","author":"Mehra","year":"2022","journal-title":"LGBT Health"},{"key":"2026030500513146900_deag003-B35","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1002\/ijgo.14194","article-title":"Parenting intentions in transgender and gender-nonconforming adults","volume":"159","author":"Morong","year":"2022","journal-title":"Int J Gynaecol Obstet"},{"key":"2026030500513146900_deag003-B36","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.jadohealth.2016.12.012","article-title":"Low fertility preservation utilization among transgender youth","volume":"61","author":"Nahata","year":"2017","journal-title":"J Adolesc Health"},{"key":"2026030500513146900_deag003-B37","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1210\/endocr\/bqac019","article-title":"Long-term hyperandrogenemia and\/or western-style diet in rhesus macaque females impairs preimplantation embryogenesis","volume":"163","author":"Ravisankar","year":"2022","journal-title":"Endocrinology"},{"key":"2026030500513146900_deag003-B38","first-page":"513","article-title":"A transgender man, a cisgender woman, and assisted reproductive technologies: a Brazilian case report","volume":"24","author":"Resende","year":"2020","journal-title":"JBRA Assist Reprod"},{"key":"2026030500513146900_deag003-B39","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1056\/NEJMc1813275","article-title":"Oocyte cryopreservation in a transgender male adolescent","volume":"380","author":"Rothenberg","year":"2019","journal-title":"N Engl J Med"},{"key":"2026030500513146900_deag003-B40","first-page":"e36484","article-title":"Gender-affirming hormone therapy: physical and sociopsychological effects, impact and satisfaction","volume":"15","author":"Santos","year":"2023","journal-title":"Cureus"},{"key":"2026030500513146900_deag003-B41","first-page":"49","volume-title":"Fertility and Fertility Preservation in Transmasculine Individuals","author":"Stark","year":"2023"},{"key":"2026030500513146900_deag003-B42","doi-asserted-by":"crossref","first-page":"102312","DOI":"10.1016\/j.bpobgyn.2023.102312","article-title":"Desire for children and fertility preservation in transgender and gender-diverse people: a systematic review","volume":"87","author":"Stolk","year":"2023","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"2026030500513146900_deag003-B43","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1089\/lgbt.2016.0153","article-title":"Parenting intentions among transgender individuals","volume":"4","author":"Tornello","year":"2017","journal-title":"LGBT Health"},{"key":"2026030500513146900_deag003-B44","first-page":"111","article-title":"Oocyte cryopreservation and reciprocal in vitro fertilization in a transgender man on long term testosterone gender-affirming hormone therapy: a case report","volume":"5","author":"White","year":"2024","journal-title":"F S Rep"}],"container-title":["Human Reproduction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/humrep\/article-pdf\/41\/3\/371\/66591527\/deag003.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/humrep\/article-pdf\/41\/3\/371\/66591527\/deag003.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T05:51:51Z","timestamp":1772689911000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/humrep\/article\/41\/3\/371\/8442394"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,27]]},"references-count":44,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,1,27]]},"published-print":{"date-parts":[[2026,3,1]]}},"URL":"https:\/\/doi.org\/10.1093\/humrep\/deag003","relation":{},"ISSN":["0268-1161","1460-2350"],"issn-type":[{"value":"0268-1161","type":"print"},{"value":"1460-2350","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2026,1,27]]}}}