The Endocrine Society

The Endocrine Society

March 25, 2019
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Transgender men prescribed testosterone therapy may have preserved ovarian function

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NEW ORLEANS — At least 1 year of testosterone therapy did not reduce anti-Müllerian hormone levels or antral follicular count in a cohort of transgender men in Israel, providing evidence for preserved ovarian reserve, according to data presented at The Endocrine Society Annual Meeting.

“These results are a further step toward providing transgender people basic rights, such as reproduction,” Yona Greenman, MD, an endocrinologist at the Institute of Endocrinology, Metabolism and Hypertension at the Tel Aviv-Sourasky Medical Center in Israel, said during a presentation.

Greenman and colleagues prospectively assessed markers of ovarian reserve in 52 transgender men (mean age, 23.4 years) undergoing therapy with testosterone enanthate (Testoviron depot) 250 mg every 3 weeks. The researchers recorded serum levels of anti-Müllerian hormone (AMH), gonadotropins and sex steroids and evaluated endometrial thickness and antral follicular count by ultrasound imaging before initiating therapy at 12 months after.

Greenman presented data from 32 of the study participants. Mean testosterone level increased from 0.84 nmol/L at baseline to 7 nmol/L at 12 months (P < .0001), and mean estradiol decreased from 90.8 pmol/L at baseline to 55.4 pmol/L at 12 months (P = .0013) as did mean luteinizing hormone from 7.56 mIU/mL at baseline to 3.8 mIU/mL at 12 months (P = .0012). Mean follicle-stimulating hormone level decreased insignificantly. Mean baseline AMH level was 5.65 ng/mL and decreased “modestly” at 12 months to 4.89 ng/mL (P = .036).

None of the participants had children. Among the entire cohort, 7% of participants underwent fertility preservation procedures before beginning testosterone therapy, and 67% reported wanting to have children. At the time of enrollment, 32% were in a stable relationship.

“The significance of these findings on fertility potential remains to be explored,” Greenman said. by Jill Rollet

Reference:

Yaish I, et al. OR11-3. Evidence for preserved ovarian reserve in transgender men receiving testosterone therapy: Anti-Mullerian hormone serum levels decrease modestly after one year of treatment. Presented at: The Endocrine Society Annual Meeting; March 23-26, 2019; New Orleans.

Disclosure: Greenman reports no relevant financial disclosures.