Table 3.
Expert agreement ratings for statements reflecting effects of gender-affirming medical treatments, established fertility preservation options, and benefits and risks of fertility preservation
| Agreement rating: n experts rating “agree” or “strongly agree”/n experts who responded to the item (%) | |
|---|---|
| 1. Sperm cryopreservation is considered an established method of fertility preservation. | 76/77 (99) |
| 2. Oocyte preservation is considered an established method of fertility preservation. | 73/77 (95) |
| 3. Specific benefits of fertility preservation procedures are unique to the individual, depending on an individual’s desires to have genetically-related children. | 72/76 (95) |
| 4. Embryo cryopreservation is considered an established method of fertility preservation. | 71/77 (92) |
| 5. Testosterone and estrogen are not effective forms of contraception. | 68/76 (89) |
| 6. Worsening gender dysphoria due to delaying GAH initiation is a risk of fertility preservation procedures. | 64/75 (85) |
| 7. Ovarian hyperstimulation is a physical/medical risk of fertility preservation procedures. | 62/74 (84) |
| 8. Worsening gender dysphoria due to invasiveness of obtaining eggs or sperm is a risk of fertility preservation procedures. | 63/76 (83) |
| 9. Cryopreserving gametes may result in “false hope” or the belief that completing fertility preservation procedures guarantees that someone will be able to have genetically-related children in the future. | 59/76 (78) |
| 10. There are financial risks to cryopreservation gametes because it is possible that someone can discontinue hormonal treatment and conceive naturally. | 58/75 (77) |
| 11. Hemorrhage or injury during follicular aspiration are physical/medical risks of fertility preservation procedures. | 57/75 (76) |
| 12. Pubertal suppression using GnRHa prevents the maturation of germ cells when used in early puberty, thus reducing fertility preservation options. | 51/77 (66) |
| 13. Estrogen may damage testicular tissue and prevent sperm production. | 48/76 (63) |
| 14. Testosterone may damage ovarian tissue and negatively affect oocyte quality. | 40/76 (53) |
Note. GnRHa = gonadotropin releasing hormone agonist (i.e., pubertal suppression treatment). GAH = gender-affirming hormones (i.e., testosterone/estrogen). Statements that met 75% agreement are listed in bold