A research breakthrough could make it easier for transgender men to have children

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There are a handful of options for those who prefer such a treatment but someday want the option of having biological children. For example, adults can freeze their eggs. But this usually involves stopping testosterone treatment and allowing the menstrual cycle to return, which can take months. Hormone-dependent drugs are used to release multiple mature eggs to stimulate the ovaries, which are then collected in a surgical procedure that involves a vaginal examination. Babayev says the process can be especially difficult for transgender men. In addition, delaying testosterone therapy for months can lead to fatigue, mood swings, and sleep problems.

D., senior national organizer of the National Center for Transgender Equality in Washington, D.C. Ojeda says many transgender men want to be able to create their own family without such interruptions.

Options are more limited for young people who want to start sex-confirming medical care before they reach puberty જે which means they can’t freeze their eggs because they haven’t started ovulating. They may choose to remove and freeze part or all of their ovaries, in which case the tissue could theoretically be replanted later પરંતુ but few trans men will choose that procedure because it will increase estrogen levels in the body, says Kenny Rodriguez. . Reproductive oncologist at the Karolinska Institute in Wahlberg, Sweden, who saw Telfer presenting his work.

The option that Telfer and his colleagues are working on involves taking eggs from the ovaries and maturing in the lab, outside the body. The team has already had some success in doing this with eggs taken from women’s ovaries, but did not know that they would be able to mature eggs from the ovaries of people who had already begun gender-confirming medical care.

Hard ovary

Telfer’s first task was to find out what testosterone therapy does for the ovaries, which is a matter of controversy among physicians.

To get a clearer idea, Telfer teamed up with two gender support clinics in the UK. Transgender men who were taking testosterone and undergoing surgery to remove their ovaries were asked if they wanted to donate it to research. A total of four people donated eight ovaries. The team compared the ovarian fragments with eight sleeves donated by women undergoing a cesarean section who were the same age.

The ovaries of transgender men were really different-they had more collagen and less elastin, which makes the tissues harder. This inertia can make it difficult for follicles to grow and release mature, ready-to-fertilize eggs.

More options [to start a family] We have trans people, the better.

Senior National Organizer of the National Center for Transgender Equality in De Ojeda, Washington, DC

Telfer and his colleagues also evaluated 4,526 follicles from eight testosterone-exposed ovarian fragments. About 94% of follicles did not grow, as opposed to 85% of women who did not take testosterone.

The team then attempted to mature the egg from the transmembrane ovary. Their method involves cutting the tissue around each follicle and then pulling it into the plate. This triggers a signaling pathway inside the tissue that allows the follicles to lay mature eggs.

It worked – the researchers were able to mature a small number of eggs to the point where they were ready to be fertilized by sperm.

In theory, the team could use IVF techniques to create an embryo with an egg, and that embryo could be transferred to the uterus of a partner or surrogate. To do this in the UK, the team needs to be licensed by the Human Fertilization and Embryology Authority. The U.S. does not require such a license.

This technique will appeal to some transgender men, says Ojeda: “More options [to start a family] We have trans people, that’s fine. ”

Telfer and his colleagues have not gone that far. The first eggs that the team matured in the laboratory did not look completely normal. When eggs mature, they usually undergo a special type of cell division that halves the number of chromosomes, preparing them for fertilization. Chromosomes that are not used are broken down into smaller cells called polar bodies. The polar bodies of the eggs matured in the laboratory looked unusually large.

The giant polar body is likely to be completely harmless. But the team is tweaking the liquid content in which the eggs mature, just in case. More recent efforts have resulted in a more typical looking egg, the Cell Telfer. The team has matured about 10 eggs so far, but the project is ongoing. “I want to strengthen our cultural system before trying to conceive,” says Telfer.

He wants to test the process in sheep before he can try it in people. Those experiments are scheduled for later this year. If they succeed, Babayev predicts that the technique will be introduced in clinics. Most fertility treatments bypass clinical trials before they are widely offered by clinics.

“Obviously Kankas will have to work, but if she succeeds, I don’t think it will take long for others to implement it very quickly,” says Babayev. But he is waiting for more evidence to confirm that the technique will work clinically. “I have to see a baby,” he says.

If it could be used to help transgender men conceive healthy children, the technique could be useful in many other circumstances, says Rodriguez-Wahlberg. Babies facing cancer treatment who may have damaged their ovaries may have their parts frozen first, giving them a way to have their own biological offspring when they grow up.

Kutluk Okte, a reproductive endocrinologist and fertility preservation specialist at the Yale School of Medicine, says the method can make it difficult for others to conceive. Cooling the ovaries may be an alternative to freezing the eggs: it is better to take a single biopsy from the ovaries than the many steps involved in egg recovery.

And while egg recovery results in about 10 eggs each time, a small piece of the ovary can be used to make 100 eggs. “A little biopsy from the ovaries … may be enough for many babies,” says Octet. “If we can figure out how to do this efficiently, it can be widely used.”

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