Oocyte Cryopreservation in Transgender and Gender-Diverse Individuals With or Without Prior Testosterone Use.

To evaluate oocyte cryopreservation among transgender and gender-diverse adolescents and young adults with or without prior testosterone exposure, we performed a retrospective cohort study of all patients younger than age 35 years referred for oocyte cryopreservation through our formal fertility-preservation program from 2014 to 2023. The number of patients referred and pursuing fertility preservation increased over time. Among the 93 patients referred, 37 pursued oocyte cryopreservation (31 testosterone-naïve and six testosterone-exposed). Among the latter, neither length of time on testosterone before presentation nor duration off testosterone before retrieval (minimum 2 months) were associated with the number of mature oocytes frozen. When comparing testosterone-naïve with testosterone-exposed individuals, there was no difference in number of oocytes retrieved (median 28 vs 32, P=0.43) or mature oocytes frozen (21 vs 21, P=0.95).

Fertility Preservation During the COVID-19 Pandemic: Modified But Uncompromised.

Purpose: Throughout COVID-19, our clinic remained operational for patients requiring urgent fertility preservation (FP). This study aimed to characterize changes to clinical protocols during the first wave of COVID-19 and compare outcomes to historical controls. Methods: We performed a retrospective cohort study at a university fertility center examining all patients who underwent medically indicated FP cycles during the American Society for Reproductive Medicine (ASRM) COVID-19 Task Force-recommended suspension of fertility treatment (March 17-May 11, 2020) and patients from the same time period in 2019. FP care was modified for safety during the first wave of COVID-19 with fewer monitoring visits and infection control measures. FP cycle characteristics and outcomes were compared across years. Results: The volume of cycles was nearly 30% higher in 2020 versus 2019 (27 vs. 19). Diagnoses, age, and anti-Mullerian hormone were similar between cohorts. More patients elected to pursue embryo cryopreservation over oocyte cryopreservation in 2020 versus 2019 (45.8% vs. 5.2%, p < 0.005). Patients managed during COVID-19 had fewer monitoring visits (5 ± 1 vs. 6 ± 1, p = 0.02), and 37.5% of cycles utilized a blind trigger injection. There was no difference in total days of ovarian stimulation (11 ± 1 vs. 11 ± 2, p > 0.05), but 2020 cycles utilized more gonadotropin (4770 ± 1480 vs. 3846 ± 1438, p = 0.04). There was no difference in total oocytes retrieved (19 ± 14 vs. 22 ± 12, p > 0.05) or mature oocytes vitrified (15 ± 12 vs. 17 ± 9, p > 0.05) per cycle. Conclusions: FP continued during COVID-19, and more cycles were completed in 2020 versus 2019. Despite minimized monitoring, outcomes were optimal and equivalent to historical controls, suggesting FP care can be adapted without compromising outcomes.