Reproductive Options For Transgender Men
The effect of prolonged treatment with exogenous testosterone on ovarian function is unclear. Testosterone therapy usually leads to anovulatory state and amenorrhea. This is usually reversible upon discontinuation of testosterone therapy, and pregnancies have been reported in transmen following prolonged testosterone treatment.
Fertility preservation options for transgender men include oocyte cryopreservation, embryo cryopreservation, and ovarian tissue cryopreservation. The frozen-thawed oocytes or embryos can then be later used for establishing a pregnancy using the patient’s uterus or by transfer into a female partner or gestational carrier. While solid data are lacking, transgender men who have initiated transition have been able to discontinue testosterone treatment and undergo insemination of sperm or IVF with embryo transfer to the patient’s uterus, a female partner or gestational carrier.
Ovarian tissue cryopreservation is currently still considered experimental. There have been several live births reported worldwide resulting after autotransplantation of cryopreserved ovarian tissue. However, there have yet to be any live births resulting from in-vitro maturation of oocytes derived from frozen-thawed ovarian tissue fragments. Research to create gametes through stem cell techniques is also ongoing.
Retinal & Choroidal Neovascularization
IVF treatment has been identified as a risk factor for retinal detachment, including a case of bilateral retinal detachment following initiation of clomiphene citrate for ovulation induction. The exact mechanism is unknown but the hypothesis is that IVF increases the levels of vascular endothelial growth factor . This is further supported by evidence showing a correlation between follicle stimulating hormone and VEGF levels. In animal models, overexpression of VEGF led to neovascularization and retinal detachment.Another report described choroidal neovascular membrane after IVF and elevated levels of VEGF may have initiated the development of CNV. Treatment with anti-VEGF through intravitreal injection was effective in reducing CNV and restoring vision.
Preserve Fertility Before Gaht At Fairfax
Individuals who want to preserve their fertility before GAHT for the future can bank their samples and store the cryopreserved samples until they are ready to build their family.
Exogenous hormones used in gender-affirming hormone replacement therapy and surgical transitioning through gonadectomy impact an individuals fertility. Estrogen, progesterone, finasteride, and other anti-androgens used in gender-affirming hormone therapy may permanently alter the bodys ability to make sperm. It is ideal to bank samples prior to beginning the use of exogenous hormones. If an individual has begun hormones it may be possible to retrieve healthy sperm after discontinuation of the hormones. Some individuals fertility has been found to be restored from 3 to 6 months after cessation of hormone therapy other individuals were not able to recover their fertility regardless of the length of time off the hormones.
In order to bank a sample at the Cryobank, one must be able to produce a sample by self-masturbation. If an individual is unable to produce a specimen, they can consult with a specialist about having sperm removed directly from the testicles. Testicular sperm cannot be used in insemination but can successfully fertilize an egg using in vitro fertilization or Intracytoplasmic sperm injection . Sperm cryopreserved by the Cryobank can be used in intrauterine inseminations , intracervical insemination , IVF, or ICSI.
There are two pathways for trans individuals to consider:
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Get The Right Treatment
Testosterone plays an active role in fertility and sperm production. Consult a reproductive specialist before starting TRT for men with low T who want to start a family. Men with low testosterone can still get pregnant without TRT. Having the correct information can help doctors make the right choice to improve the chances of pregnancy.
Blepharophimosis Ptosis Epicanthus Inversus Syndrome
Blepharophimosis, ptosis, epicanthus inversus syndrome is an eyelid malformation characterized by BPES and telecanthus. The condition is autosomal dominant. BPES is considered type I when present in association with POI. Type II BPES is not associated with POI. Forkhead transcription factor L2 mutations are associated with BPES .
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Pregnancy After Frozen Embryo Transfer
Right after the embryo transfer, a woman can continue a normal life, however, during the first three days , it is advisable to limit activity. 3 days after the embryo transfer, it is possible to travel for long distances, in particular by train or car.It is also recommended to: walk in the fresh air, sleep about 8 hours a day have a balanced diet, including high-fiber foods, sufficient fluid intake control stool and urination comply with all medical recommendations of a fertility specialist avoid staying in crowded places, especially during epidemics exclude heavy physical exertion
Side Effects Of Hormone Replacement Therapy
Once youve started with HRT, you may experience certain side effects. Most of them are minor and eases with time as the body gets used to the treatments. Some of the common side effects of HRT include acne, nausea, mood swings, and headache.
However, if effects such as breast tenderness, cramps, bleeding persist for a long period of time, its imperative that you speak with your doctor. Your medicine will be altered or the dosage will be lowered to get rid of these effects.
A common myth about hormone replacement therapy is that it leads to weight gain. Although there is no evidence to prove this, its essential to follow a healthy lifestyle while taking the therapy. Exercising regularly and eating healthy will keep you fit and will aid in bringing your hormones in sync.
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Types Of Fsh Replacement For Male Infertility Problems
Exogenous FSH comes in two commercially available forms. Human menopausal gonadotropins is FSH that has been extracted from the urine of postmenopausal women. It comes in two types: menotropins , which contain both FSH and HCG, and urofollitropins , which contain just purified FSH. The other form is recombinant FSH , which contains purified FSH that has been produced in the lab from genetically modified cells. Commercially available forms include Follistim and Gonal-F.
All FSH is given by subcutaneous or intramuscular injection. HMG comes in vials and is drawn up in syringes for use, and Gonal-F is available in this form as well. Follistim and Gonal-F are also available in ready-to-use injectable pens that can be dialed to the selected dose. There have not been any data reliably showing that one form is safer or more effective than the other for male fertility treatment.
Hormone Therapy For Fertility
Hormone therapy can help relieve the symptoms of menopause. It can replace female hormones no longer made by the ovaries. In some cases, you may begin hormone therapy before menopause. If you are taking birth control pills, they will be stopped when you begin treatment.
For women with a uterus, estrogen usually is given along with progestin. This helps reduce the risk of cancer of the lining of the uterus that occurs when estrogen is used alone. The progestin may be taken every day with estrogen, or estrogen may be taken on some days and the progestin added on others.
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Bioidentical Hormone Replacement Therapy
Bioidentical hormone replacement therapy, or BHRT for short, is a form of therapy that uses synthetic hormone compounds identical to natural human hormones. Patients with hormone imbalances will have baseline blood work performed, and the doctor will prescribe treatment based on the results of these labs. This blood work is typically performed on the date of the patients first consult but can be scheduled at a later date if needed.
The Fertility Center offers Bioidentical hormone replacement therapy services for clients from Nashville, Atlanta, Knoxville, Chattanooga, and beyond! Our two offices are in Chattanooga and Knoxville.
Trt May Not Be Beneficial For Fertility
Testosterone replacement comes in a gel, patch, or injection to restore to healthy levels. TRT is helpful for men with low energy levels, poor focus, low sex drive, and a host of other issues. Studies show that TRT decreases the chances of conceiving. This is identified frequently in men that have been taking the medication over long periods.
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Is Hormone Replacement Therapy Effective To Treat Infertility
Estrogen and progesterone are the most important hormones that play a vital role in regulating a womans reproductive system. Its essential for the hormones to perform in sync to ensure a healthy reproductive system. An imbalance of these two hormones can lead to many types of infertility in women including premature ovarian failure. It can also lead to a thin uterine lining that leads to failure of pregnancy.
Hormone replacement therapy works by replenishing the necessary hormones, thus increasing the chances of conception. This treatment is also effective in case of infertility that arises from irregular ovulatory cycles. So if youre wondering whether you can get pregnant on HRT, the answer is yes. With the right combination and dosages of hormones, it can be very effective for those struggling with infertility.
Pills, patches, creams, gels are the most common ways of taking Hormone Replacement Therapy. The combinations that are suitable for you will be decided after checking your medical history.
Bone Morphogenetic Protein 15
Bone morphogenetic protein 15 is a growth/differentiation factor specific to oocytes. The factor is involved in many cellular processes, including follicular development . The condition may present as either primary or secondary amenorrhea. Mutations in this gene account for the mechanism of POI in about 1.515% of cases .
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Side Effects And Risks
Interfering with the hormone balance can entail side effects and risks, which the attending physician will explain individually before the treatment. In addition, during the treatment period, the doctor will regularly monitor egg maturation and hormone levels in order to avoid overdosing and to minimise the risks.
Possible side effects of the treatment include:
How Does Hormone Replacement Therapy Work
Hormone replacement therapy is most commonly used to help alleviate the symptoms of menopause in women. But that doesnt mean that hormone replacement therapy cant also help with fertility.
In many cases of infertility, women are unable to become or stay pregnant due to a hormone deficiency, usually a lack of adequate progesterone. By utilizing hormone replacement therapy, progesterone, estrogen, and other female reproductive hormones that may be lacking can be administered.
It should be noted that HRT is not generally recommended for male infertility, as testosterone hormone replacement therapy has been known to decrease sperm production.
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Who Should Not Take Hormone Replacement Therapy
The benefits of hormone replacement therapy are well-known, but it should be kept in mind that its not for everyone. Like every treatment, hormone replacement therapy also has some risks associated with it such as risks of blood clots. Its therefore not recommended for people with increased risk of heart attacks. Its also not suitable for those who have high blood pressure or a history of blood clots. Furthermore, if you have a history of cancer, stroke, liver, or gallbladder disease, its recommended to consider alternate ways of treatment.
Its always advisable to seek guidance from an experienced doctor to discover if hormone replacement therapy is suitable for you.
Infertility & Excessive Prolactin Hormone
An excessive of the hormone prolactin can suppress follicle stimulating hormone and luteal hormone both of which are vital for ovulation. Women produce prolactin when breastfeeding, which is why there is a decreased possibility of conception while a mother is still nursing her infant.
In rare cases, a woman can also have a small pituitary tumor which produces prolactin and prevents ovulation, causing infertility. So, checking prolactin hormone levels should always be part of the evaluation for women having difficulty becoming pregnant.
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The Misuse Of Testosterone As A Fertility Treatment
If the risks of TRT were widely known and talked about openly by doctors and patients alike, this wouldnt be such a big problemeach man could decide for himself is the risk is acceptable. But many men dont know that their testosterone medications could be impacting their fertility in both the short and long term. Even worse, some doctors are still prescribing testosterone to treat infertility. One survey of practicing American Urological Association members found that 25% of respondents were prescribing TRT to infertile men who were actively pursuing pregnancy. International studies have had similar results and indicate that a significant number of practitioners incorrectly believe that testosterone therapy increases sperm count.
In some ways, the thought process makes sense. Testosterone plays some part in the reproductive function of the male body. If a man is found to be infertile, why not administer doses of this incredibly accessible treatment?
Its all a matter of education. The doctors who prescribe TRT as male infertility treatment arent aware of the consequences and may not have the necessary qualifications to be administering complex hormone treatment in the first place. More education on the effects of exogenous testosterone on male fertility could help reduce this unfortunate occurrence.
Can I Get Pregnant On Hormone Replacement Therapy
Hormone replacement therapy is an effective treatment commonly used to relieve the uneasy symptoms of menopause. Its a common remedy to help women with vaginal dryness, night sweats, and hot flashes that result from lower levels of hormones. The fortunate news is that now HRT is not just restricted to give relief to these symptoms, but also to treat infertility.
Studies have found that Hormone Replacement Therapy has triggered natural pregnancy in women even beyond the age of 58. So if youve asked yourself, Can I get pregnant on Hormone Replacement Therapy?, this article is for you.
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Women Can Benefit Too
Having healthy testosterone levels isnt just for men. Women also benefit from healthy androgen levels. Some women suffer from low libido, reduced bone mass, and lower energy levels. With a consistent TRT regimen, there is often a significant improvement in these symptoms. There is a need for a delicate balance since there is a dependence on other hormones for reproduction. For fertility, abnormally high testosterone levels can create an opposite effect.
Does Trt Help Or Hurt Your Fertility
For some couples trying to conceive, infertility could be a challenge. The conversation is often centered around women, but men struggle with fertility too. The causes of infertility are numerous and well documented. Theres a common perception that low testosterone causes infertility. This belief has caused a rise in thinking that testosterone replacement therapy can help a couple conceive. Studies show that TRT can do more harm than good.
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Gonadotropin Receptors Fsh And Lh
FSH and LH receptors belong to the G-protein-coupled receptors family. These receptors regulate reproductive hormone signaling by interacting with FSH and LH in both men and women. Loss-of-function mutations in these receptors result in resistance to gonadotropin stimulation and present with hypogonadotropic hypogonadism .
Reasons Patients Need Hormone Replacement Therapy
Hormone Replacement Therapy for Women
The number one reason women need hormone replacement therapy is Menopause. Around the age of 50 women naturally see a decline in their reproductive hormones, estrogen, and progesterone. This process is completely normal, but it can seem to affect the day to day lives of many women. Through menopause, women suffer through hot flashes, chills, night sweats, sleep problems, weight gain, mood changes, thinning hair, and dry skin. Weve helped women experiencing menopause by introducing estrogen and progesterone back into their system with bioidentical hormone replacement therapy.
Hormone Replacement Therapy for Men
Women arent the only ones who can fall victim to hot flashes, irritability, mood swings, night sweats, and sleep disturbances. Men can also experience hormone imbalances that bring on acne, weight gain or loss, and depression, among other changes. As men age, they tend to stop producing the male hormone, testosterone. Were able to treat male hormonal imbalance through testosterone replacement therapy. View our Hormone Therapy for Men page for more info.
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Selective Oestrogen Receptor Modulators
SERMs are group of pharmaceutical agents that act by the competitive inhibition of oestrogen receptors in the hypothalamus and pituitary with subsequent increased release of GnRH and gonadotrophins thus increase intra-testicular testosterone production and enhance spermatogenesis. In addition, it remains uncertain whether there is also an additional direct effect of anti-oestrogens on spermatogenesis or steroidogenesis at the testicular level .
Clomiphene citrate as a chemical compound is composed mainly of a racemic mixture of two isoforms enclomiphene and zuclomiphene. Several studies have used CC as an anti-oestrogen in the treatment of azoospermia, oligozoospermia and unexplained infertility, as well as for the treatment of hypogonadism independent from infertility. They demonstrated that CC causes moderate elevations in LH, FSH, total testosterone and sperm concentrations in such patients .
Concerning the impact of CC therapy on the pregnancy rate, two studies reported increased rates. Ghanem et al. evaluated the combination of CC and vitamin E vs placebo and found that pregnancy rates were significantly higher in the treatment groups . In addition, Chua et al. conducted a meta-analysis of oestrogen antagonists that showed a statistically significant increase in sperm concentration as well as an increased pregnancy rate.
Hormone Replacement Therapy And Fertility
For premenopausal people with ovaries, taking estrogen or progesterone can help correct irregular ovulatory cycles and imbalances, creating a more ideal ovarian and uterine environment for a pregnancy to occur.
Conversely, for people with testes, taking supplemental testosterone can be detrimental to fertility. Exogenous testosterone affects the hypothalamic-pituitary gonadal axis, shutting down the production of other hormones that are essential for sperm development. Studies show that testosterone replacement therapy can halt sperm production altogether, though the effect is typically temporary.Transgender individuals who undergo gender-affirming hormone therapy are also at risk for infertility. Research shows that testosterone therapy in transgender men can suppress ovulation, while estrogen therapy in transgender women can result in impaired spermatogenesis and testicular atrophy. This is why transgender patients are often encouraged to consider sperm freezing or egg freezing to preserve their fertility options.
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