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Hormone Replacement Therapy (HRT) Client Fertility Preservation

Preserve Fertility Before HRT at Fairfax

Individuals who want to preserve their fertility before HRT for the future can bank their samples and store the cryopreserved samples until they are ready to build their family.

Exogenous hormones used in gender-affirming hormone replacement therapy (HRT) and surgical transitioning through gonadectomy (removal of the testes) impact an individual’s fertility. Estrogen, progesterone, finasteride, and other anti-androgens used in gender-affirming HRT may permanently alter the body’s ability to make sperm. It is ideal to bank samples prior to beginning use of exogenous hormones. If an individual has begun hormones it may be possible to retrieve healthy sperm after discontinuation of the hormones. Some individuals’ fertility has been found to be restored from 3 to 6 months after cessation of hormone therapy; other individuals were not able to recover their fertility regardless of the length of time off the hormones.

Trans individuals should be educated and counseled regarding options for fertility preservation. Again, banking samples prior to the initiation of pubertal suppression and treatment with gender-affirming hormones are recommended. It is not possible for pre-pubertal individuals to bank their samples at the Cryobank.  If your child has had puberty suppressed using gonadotropin-releasing hormone (GnRH) analogs, it should be possible for them to resume puberty with the cessation of the treatment which would allow them to produce a sample for cryopreservation. Most children who undergo pubertal suppression will skip the puberty process and begin gender-affirming HRT, which would leave them unable to produce a specimen for cryopreservation.

Decisions made regarding fertility preservation and cessation or delay of gender-affirming HRT should be preceded by a discussion with a counselor.

In order to bank a sample at the Cryobank, one must be able to produce a sample by self-masturbation.  If an individual is unable to produce a specimen, they can consult with a specialist about having sperm removed directly from the testicles.  Testicular sperm cannot be used in insemination but can successfully fertilize an egg using in vitro fertilization (IVF) or Intracytoplasmic sperm injection (ICSI).  Sperm cryopreserved by the Cryobank can be used in intrauterine inseminations (IUI), intracervical insemination (ICI), IVF, or ICSI.

There are two pathways for trans individuals to consider:

  • You are banking for use in the future with a non-sexually intimate recipient,
    e.g. Gestational Carrier/Surrogate will carry the pregnancy

    In this instance you will proceed as a Directed Donor*

  • You are banking for use in the future with a sexually intimate recipient,
    e.g. your future partner will carry the pregnancy

    In this instance, you will proceed as a Client Depositor 

If you are unsure of how the sample will be used in the future, you can proceed through the Cryobank’s Enhanced HRT Program.

Enhanced HRT Process

For individuals who are unsure of the future recipient of their cryopreserved sperm samples, Fairfax Cryobank offers our Enhanced HRT Client Depositor Program.  We recommend that clients have a physical exam with their health provider around the time of their appointment to bank their sample for cryopreservation.  On the day of the on-site consultation, the client will produce a urine sample and have blood drawn for FDA required infectious disease testing.  This blood draw must occur on-site at our facility. They will also complete an FDA required screening questionnaire. 

Semen Cryopreservation Services: Storing Your Own Sperm

Semen Evaluation Only$150/specimen
Semen Specimen Evaluation, Standard Process, and Freeze (unwashed)$350/specimen
Semen Specimen Analysis, Prewashed Process, and Freeze$460/specimen
Initial Visit Consultation$150
Blood Panel (includes the FDA required testing, must be done on-site at the Cryobank) & Questionnaire$140
Semen Specimen Release (handling)$45
Storage FeesSperm Storage Fees

* This pathway exists because the FDA regulates the storage and use of sperm samples with non-sexually intimate recipients.

Trans Family Resources

  • Strong Family Alliance: Resource for parents/families regarding LGBTQIA+ children, a great Parents Guide
  • TransLifeline: Volunteer-based crisis lifeline staffed by transgender people for transgender people
  • GSA Network: National organization of LGBTQ youth organizers of gay/straight student organizations from middle school to high schools
  • Gender Spectrum: Provides education, training, and support to help create a gender-sensitive and inclusive environment for all children and teens
Rainbow FlagsTrans Fertility ConsiderationsBeyond Inclusion LGBTQ 101