New sperm preservation technique helps infertile and transgender men

Doctors have developed a new method for collecting viable semen that can help people receiving estrogen therapy and men with low fertility Having children without the need for surgical procedures or the chance of complications: this is the so-called extended freezing and search for sperm (ESSM), which makes it possible to collect the material in any situation, except when sperm production is zero.

Some transgender women, for example, may take medications that decrease testosterone production and increase estrogen, causing sperm production to decrease or stop altogether.

In a recent case, urologist Michael Werner, for example, was able to collect – via ESSM – more than 200 viable sperm from a transgender woman who had been on hormone therapy for 18 years, even though she had taken a 10 month break to try to conceive. This was the first time that viable sperm were collected from a transgender woman two years after starting hormone therapy.

Fertility and medical procedures

For the normal production of sperm, continuous production of testosterone is required in the testicles: 40 million per ejaculation is considered normal. For ESSM, a technology created in 2017, this is not necessary. With it, it is possible to find small samples of material that are ejaculated and frozen without harmful effects, even in people with years of hormone therapy or men with low sperm counts.

Previously, harvesting involved inserting a needle into the testicles, which could be painful and dangerous for the organ. In the new technique, semen samples are broken down into tiny droplets and scanned with high-powered microscopes for hours, looking for viable material and placed individually in a specialized device called a SpermVD for cryopreservation. More than 90% of sperm survive freezing and thawing.

In the United States, where surgery has been going on for some time, doctors are reporting that more and more people feel safe identifying as transgender, and are seeking hormonal therapy and medical interventions. However, there is a need to improve care while preserving fertility before hormonal therapy – otherwise, the likelihood of having biological children in the future is significantly reduced.

Risks and Advantages

The chances of miscarriage are higher when using ESSM, such as Sperm Collected with this technique becomes more fragile due to the time it takes to cross the epididymis, one of the ducts of the male reproductive system, in order to ejaculate. In surgical removal, sperm and gamete DNA are more robust.

In addition to people taking hormone therapy, there is a benefit to some of the Infertile men: 1% to 2% of them suffer from what is called severe oligospermia, when there is no detectable sperm in the semen. Half of infertile couples are victims of this condition.

Men with oligospermia actually have a higher risk of causing a pregnancy that can end in miscarriage, because the disease damages sperm, but it is still better to use ESSM than to collect sperm by surgery. As with any surgery, there is a risk of complications for the patient.

In Claire’s case, one of Dr. Werner, it was possible to collect 30 IVF cycles in the future: as long as sperm production is normal, future fertility can be preserved. Physician encourages transgender women who plan to undergo hormone transitions and/or undergo surgical procedures for research Preserve your fertility Most don’t get the choice, and it’s often too late when they seek biological children.

source: New York times