Table 1.

Fertility preservation options for transmen.

Fertility Preservation Method	Protocol	Advantages	Limitations
Oocyte cryopreservation	COS cycles requiring about 2 weeks of daily gonadotropin injections to induce hyperstimulation of ovaries followed by oocyte retrieval under anesthesia	Well-established method No need for partner Autonomy over gametes	Post-pubertal patients only Pelvic exams, transvaginal ultrasonography required Cessation of gender-affirming hormonal therapy recommended Menstruation may resume Hormonal treatment may lead to gender dysphoria Invasive method involving anesthesia Lower survival rate compared to that of embryos
Embryo cryopreservation	COS cycles requiring about 2 weeks of daily gonadotropin injections to induce hyperstimulation of ovaries followed by oocyte retrieval under anesthesia	Well-established method Confirmation of the quality of embryos developed from retrieved oocytes (good quality embryos have higher survival rate) Preimplantation genetic testing to check for aneuploidy	Post-pubertal patients only Pelvic examination, transvaginal ultrasonography required Cessation of gender-affirming hormonal therapy recommended Menstruation may resume Hormonal treatment may lead to gender dysphoria Invasive method involving anesthesia Lack of autonomy due to need for sperm (from partner or sperm donor) and dual consent when using embryos
Ovarian tissue cryopreservation with IVM	Preparation of the sample is done via surgery, then cryopreserved, most commonly during gender-affirming surgery	Only available option for prepubertal transgender patients No need for cessation of gender-affirming hormonal therapy and pelvic exams leading to gender dysphoria	Invasive method involving surgery Need for autologous transplantation into the pelvic cavity Not widely applied due to lack of clinical data

COS: controlled ovarian stimulation; IVM: in vitro maturation.