She wanted to have a family. She knew that it could be complicated.
If possible, they would use her sperm and her partner's egg to have a baby. She spoke on the condition of anonymity to protect her family's privacy, and the chances of doctors finding viable sperm were slim.
She was going to have a vaginoplasty at the same time. She would have her penis and testicles removed and her vagina created.
Estradiol and testosterone are drugs that transexual women take to suppress testosterone production. Unless sperm production has stopped completely, a new procedure called E.S.S.M. makes it possible to retrieve that sperm.
After using E.S.S.M., Dr. Michael Werner was able to find and freeze more than 200 viable sperm. After more than two years of hormone treatments, doctors were able to retrieve viable sperm in a trans woman.
The E.S.S.M. technique was created by Dr. Arie Berkovitz at Assuta Hospital in Israel.
40 million total per ejaculate is considered normal testosterone production in the testicles is required for sperm production Sperm production is not increased by E.S.S.M. Doctors are able to find and freeze small amounts of sperm from the ejaculate without side effects if they use E.S.S.M. Patients with low sperm counts or thoughts to have no sperm at all used to have to have an intrusive surgery in which sperm was removed through a needle. The process can cause pain.
Claire said that she did the procedure for peace of mind. It was both amazing and overwhelming when I received the call that there were so many sperms.
The semen sample is divided into tiny droplets and scanned using a high-powered microscope. The sperm is placed in a device called a SpermVD and frozen. The majority of them survive the freeze-and-thaw process.
Dr. Joshua Safer is the executive director of the Center for Transgender Medicine and Surgery at the Mount Sinai Health System.
He said that he was amazed and impressed. He said that they don't know what the limits are.
At her doctor's suggestion, she went to a fertility clinic in Boston to see if the bank would be able to retrieve and store her sperm before her surgery. Even though she stopped taking her hormones 10 months before, the clinic couldn't find any gametes in her ejaculate.
She was referred to the fertility clinic and sperm bank by her urologist. rescheduling could take a long time, given the waiting list, since her vaginoplasty was just one day away. She was surprised by the result of E.S.S.M.
Dr. Eric K. Seaman is a urologist who specializes in male reproductive health in Millburn, N.J.
He said it was a miracle that they were able to find any sperm after 18 years of therapy.
About 1.6 million people in the US identify as trans. It's possible that E.S.S.M. can be used to preserve sperm for trans women.
Dr. Safer believes that this technology could benefit his patients. The Mount Sinai Center for Transgender Medicine and Surgery has seen a surge in the number of people seeking treatment. 800 to 900 gender-affirming surgeries are performed annually by the center.
He said that more and more people are choosing to identify as trans and have medical interventions. In the gender-affirming care world, our clinics need to do a better job of getting children to do fertility preservation before they get on hormones.
Dr. Seaman was worried that the use of E.S.S.M could lead to an increase in the number of miscarriages.
The treatment is not only for trans women. Half of all infertile couples have male factor infertility, which is a condition in which no sperm is found in the semen.
The procedure of semen retrieved using E.S.S.M. is less risky than the procedure of semen removed from the testes.
He said that sperm can be retrieved from the testes with no problems.
Men with severe male factor infertility are more likely to cause pregnancies that result in miscarriage because their sperm may be damaged.
Dr. Berkovitz said that E.S.S.M. shouldn't interfere with a woman's reproductive health if she has normal sperm production.
She didn't have a low sperm count. Her fertility was preserved because her sperm was normal.
Doctors were able to freeze enough sperm for her to have at least 30 cycles of fertility treatment.
He said it was a second chance for people who are trans. It's possible to offer fertility preservation without any pain or discomfort.
Dr. Werner encourages young people who are trans to have their sperm banked so that they don't have to worry about losing their fertility.
The vast majority of trans women who are transitioning aren't given the option to bank their sperm, and once they're put on hormones and have their testes removed, their options have closed
He is seeing more women come to the clinic to have their sperm banked.
She said she wanted to seek guidance sooner.
She said she would encourage young people to store their sperm. I wish I did it sooner.
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