Oocyte cryopreservation in the premenarchal transgender boy on blockers: a case series

The World Professional Association for Transgender Health, Endocrine Society, and American Society of Reproduction all recommend counseling transgender men on Assisted Reproductive Technologies (ART) and fertility preservation (FP) before initiation of gender-affirming treatment (GAT) (1). As a result, there is a growing number of adolescents on pubertal suppressive agents presenting for discussion of FP (2,3). Pubertal suppression with a GnRH agonist has been well-documented as reversible, allowing reactivation of pubertal development and secondary sexual characteristics consistent with natal sex upon cessation of treatment (4,5,6). The practicality of cryopreservation of oocytes is uncertain in patients who have not completed puberty. There are two published reports of prepubescent adolescents who underwent controlled ovarian stimulation (COS) while still on GnRH agonist pubertal suppression (7,8).