Effects of Cross-Sex Hormone Replacement Therapy on Fertility in Transgender Patients: A Systematic Review

Undergraduate Honors Thesis

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Citeable URL: https://scholar.colorado.edu/concern/undergraduate_honors_theses/2n49t2555

Abstract

A growing area of research among the scientific community is the methods and effects of medical transition for transgender patients. One common component of medical transition is the administration of exogenous cross-sex hormones to patients to obtain a masculinized or feminized phenotype, referred to as hormone replacement therapy (HRT). There is limited research on much of these effects, including the effects of HRT on patients’ fertility. In this study, I conducted a systematic review of research on the impacts of HRT on fertility, including calculating risk ratios and etiologic fractions. Thirty-nine papers were examined both qualitatively and quantitatively to assess the impacts of HRT on semen quality, ovulation, polycystic ovary morphology, and endometrial function. This study found that HRT reduces fertility in transgender patients, but not universally or completely; there is still evidence of fertility during HRT administration in many patients. Following discontinuation of HRT, reduced fertility will return to its pre-HRT status in most patients. This research will help clinicians counsel their transgender patients on fertility before and after their medical transition.

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