Last Updated on September 21, 2023 by Shabnam Sengupta
Transgender individuals have the option to transition from female to male (transman or FTM) or male to female (transwoman). The gender affirmation process may involve emotional, social, medical, and surgical aspects of transition. However, not all transgender individuals opt for medical or surgical intervention. Some choose to undergo gender-affirming procedures to alter their physical appearance to align with their gender identity, either by masculinising or feminising certain body parts. It is worth noting that orchiectomy is a common surgical procedure for transgender women that entails the surgical removal of one or both testicles. It is a significant procedure that can have implications for fertility. For those who are considering orchiectomy for gender affirmation, a common question is whether they will be able to have children in the future.
This article examines the effects of orchiectomy on fertility and discusses the available options for transgender individuals after the procedure. Additionally, this article emphasises the importance of consulting with healthcare professionals to make informed decisions.
What effects does an orchiectomy have on fertility?
After undergoing an orchiectomy, the surgical removal of the testicles, there is a significant impact on a person’s fertility. This is because the testicles play a crucial role in sperm production, affecting their ability to have a biological child.
You must know that since sperm production ceases during an orchiectomy, sterility is usually permanent. This is a crucial consideration for those who want to preserve their fertility for potential future family planning. This is due to the fact that the removal of the testicles, which produce sperm, makes natural conception difficult.
Transgender women who undergo orchiectomies as part of their gender transition frequently use hormone therapy (HT). Doctors give oestrogen during HT to promote the development of secondary feminine sexual traits. It is important to understand that HT can affect fertility on its own, and taking oestrogen may further diminish sperm production.
What options are available for fertility after undergoing an orchiectomy for gender affirmation?
Sperm banking is an important consideration for those who wish to have biological children after undergoing an orchiectomy. This process involves the collection, freezing, and long-term storage of sperm prior to surgery. Preserved sperm can later be used for in vitro fertilization (IVF) or artificial insemination. This provides the individuals with the opportunity to have biological children even after undergoing an orchiectomy.
Fertility preservation through sperm banking can be influenced by various factors. These factors include the age of the individual at the time of sperm collection and the quality and quantity of preserved sperm. It is advisable for individuals to explore this option well in advance of undergoing orchiectomy. In cases where sperm banking is not possible or the quality or quantity of preserved sperm is insufficient, donor sperm is an alternative option. Donor sperm can be used in IVF or artificial insemination to achieve pregnancy. For transgender women who have transitioned, egg or embryo donation can be considered. Donated eggs or embryos can be utilized, with the assistance of a gestational carrier (surrogate), to achieve pregnancy. IVF, however, has downsides in three key domains. These primarily include the likelihood of success, the cost of therapy, and any potential health concerns for the mother and foetus from multiple births.
Please understand that after an orchiectomy, these treatments offer a potential possibility for transgender women to pursue biological parenting. Success, however, may depend on a number of variables. These primarily include the caliber and accessibility of preserved sperm or the selection of substitute procedures like donor gametes or surrogacy. To increase the likelihood of parenthood in the future, it is important to carefully consider these options prior to undergoing an orchiectomy.
What is the significance of seeking medical advice for family planning following an orchiectomy?
Orchiectomy results in permanent sterility as it stops sperm production. Therefore, individuals who wish to have biological children should consult with healthcare providers and make informed decisions regarding fertility preservation. It is crucial for individuals to have open and informed discussions with their healthcare providers about the complexities surrounding fertility and orchiectomy. A knowledgeable healthcare provider can offer guidance on fertility preservation options. These options include sperm banking which could help individuals make informed decisions that align with their family planning goals. Despite the impact of orchiectomy on fertility, proactive measures can still enable individuals to have children in the future. This would ensure that they have options for family planning even after undergoing this transformative surgery.
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