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Chapter 32 - The Ovaries under Supraphysiological Androgen Exposure

from Section F - Impact of Gender-affirming Hormonal Therapy on Genital Organs

Published online by Cambridge University Press:  22 December 2022

Mick van Trotsenburg
Affiliation:
Sigmund Freud PrivatUniversität, Wien
Rixt A. C. Luikenaar
Affiliation:
Rebirth Health Center, Utah
Maria Cristina Meriggiola
Affiliation:
Università di Bologna
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Summary

Ovaries are the reproductive organs of women, producing the gametes and sex hormones.

The production of sex hormones is important for the regulation of ovarian function and menstrual cyclicity. Trans men undergo testosterone treatment or/and gender re-affirming surgery in order to overcome gender dysphoria. This treatment might result in the cessation of the normal ovarian function. For trans men that wish to retain their fertility options, ovarian function remains a prerequisite for genetically related offspring. Fertility treatments for trans men may occur before or in between testosterone treatment. Treatments following testosterone supplementation may have an effect in the proper ovarian function. This chapter deals in detail with the effects of testosterone on the ovarian anatomy and physiology.

Type
Chapter
Information
Context, Principles and Practice of TransGynecology
Managing Transgender Patients in ObGyn Practice
, pp. 236 - 242
Publisher: Cambridge University Press
Print publication year: 2022

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References

Nahata, L, Chen, D, Moravek, MB, et al. Understudied and under-reported: fertility issues in transgender youth—a narrative review. J Pediatr 2019;205:265271. https://doi.org/10.1016/j.jpeds.2018.09.009Google Scholar
De Roo, C, Tilleman, K, T’Sjoen, G, De Sutter, P. Fertility options in transgender people. Int Rev Psychiatry 2016;28:112119. https://doi.org/10.3109/09540261.2015.1084275Google Scholar
Shea, LD, Woodruff, TK, Shikanov, A. Bioengineering the ovarian follicle microenvironment. Annu Rev Biomed Eng 2014;16:2952. https://doi.org/10.1146/annurev-bioeng-071813-105131CrossRefGoogle ScholarPubMed
He, X. Microfluidic encapsulation of ovarian follicles for 3D culture. Ann Biomed Eng 2017;45:16761684. https://doi.org/10.1007/s10439-017-1823-7.Google Scholar
Rimon-Dahari, N, Yerushalmi-Heinemann, L, Alyagor, L, Dekel, N. Ovarian folliculogenesis. In Piprek, RP, Ed. Molecular Mechanisms of Cell Differentiation in Gonad Development. Cham: Springer, 2016, pp. 167190. https://doi.org/10.1007/978-3-319-31973-5_7Google Scholar
Kim, SY, Kim, SK, Lee, JR, Woodruff, TK. Toward precision medicine for preserving fertility in cancer patients: existing and emerging fertility preservation options for women. J Gynecol Oncol 2016;27:118. https://doi.org/10.3802/jgo.2016.27.e22Google Scholar
Williams, CJ, Erickson, GF. Morphology and Physiology of the Ovary. Endotext 2012.Google Scholar
Hennet, ML, Combelles, CMH. The antral follicle: a microenvironment for oocyte differentiation. Int J Dev Biol 2012;56:819831. https://doi.org/10.1387/ijdb.120133ccGoogle Scholar
Gougeon, A. Regulation of ovarian follicular development in primates: facts and hypotheses. Endocr Rev 1996;17(2):121155. https://doi.org/10.1210/edrv-17-2-121Google Scholar
Gougeon, A. Dynamics of follicular growth in the human: a model from preliminary results. Hum Reprod 1986;1:8187. https://doi.org/10.1093/oxfordjournals.humrep.a136365Google Scholar
Telfer, EE. Progress and prospects for developing human immature oocytes in vitro. Reproduction 2019;158:F45F54. https://doi.org/10.1530/REP-19-0077CrossRefGoogle ScholarPubMed
Hawkins, SM, Matzuk, MM. Menstrual cycle: basic biology. Ann N Y Acad Sci 2008;1135:1018. https://doi.org/10.1196/annals.1429.018Google Scholar
Reed, BG, Carr, BR. The Normal Menstrual Cycle and the Control of Ovulation. Endotext 2018.Google Scholar
Walters, KA, Handelsman, DJ. Role of androgens in the ovary. Mol Cell Endocrinol 2018;465:3647. https://doi.org/10.1016/j.mce.2017.06.026Google Scholar
Zhang, Y, Zhang, C, Shu, J et al. Adjuvant treatment strategies in ovarian stimulation for poor responders undergoing IVF: a systematic review and network meta-analysis. Hum Reprod Update 2020;26:247263. https://doi.org/10.1093/humupd/dmz046Google Scholar
Light, AD, Obedin-Maliver, J, Sevelius, JM, Kerns, JL. Transgender men who experienced pregnancy after female-to-male gender transitioning. Obstet Gynecol 2014;124:11201127. https://doi.org/10.1097/AOG.0000000000000540Google Scholar
Krempasky, C, Harris, M, Abern, L, Grimstad, F. Contraception across the transmasculine spectrum. Am J Obstet Gynecol 2020;222:134143. https://doi.org/10.1016/j.ajog.2019.07.043CrossRefGoogle ScholarPubMed
Irwig, MS. Testosterone treatment for transgender (trans) men. In Legato, MJ, Ed. The Plasticity of Sex. New York: Academic Press, 2020, pp. 137157. https://doi.org/10.1016/B978-0-12-815968-2.00012-8CrossRefGoogle Scholar
Amir, H, Yaish, I, Samara, N, et al. Ovarian stimulation outcomes among transgender men compared with fertile cisgender women. J Assist Reprod Genet 2020;37:24632472. https://doi.org/10.1007/s10815-020-01902-7Google Scholar
Adeleye, AJ, Cedars, MI, Smith, J, Mok-Lin, E. Ovarian stimulation for fertility preservation or family building in a cohort of transgender men. J Assist Reprod Genet 2019;36:21552161. https://doi.org/10.1007/s10815-019-01558-yGoogle Scholar
Lierman, S, Tilleman, K, Braeckmans, K, et al. Fertility preservation for trans men: frozen-thawed in vitro matured oocytes collected at the time of ovarian tissue processing exhibit normal meiotic spindles. J Assist Reprod Genet 2017;34:14491456. https://doi.org/10.1007/s10815-017-0976-5Google Scholar
De Roo, C, Lierman, S, Tilleman, K, et al. Ovarian tissue cryopreservation in female-to-male transgender people: insights into ovarian histology and physiology after prolonged androgen treatment. Reprod Biomed Online 2017;34:557566. https://doi.org/10.1016/j.rbmo.2017.03.008CrossRefGoogle ScholarPubMed
Lierman, S, Tolpe, A, De Croo, I, et al. Low feasibility of in vitro matured oocytes originating from cumulus complexes found during ovarian tissue preparation at the moment of gender-confirmation surgery and during testosterone treatment for fertility preservation in transgender men. Fertil Steril 2021;116:1068–76. https://doi.org/10.1016/j.fertnstert.2021.03.009CrossRefGoogle ScholarPubMed
Uzelac, PS, Delaney, AA, Christensen, GL, Bohler, HC, Nakajima, ST. Live birth following in vitro maturation of oocytes retrieved from extracorporeal ovarian tissue aspiration and embryo cryopreservation for 5 years. Fertil Steril 2015;104:12581260. https://doi.org/10.1016/j.fertnstert.2015.07.1148Google Scholar
Segers, I, Mateizel, I, Van Moer, E, et al. In vitro maturation (IVM) of oocytes recovered from ovariectomy specimens in the laboratory: a promising ‘ex vivo’ method of oocyte cryopreservation resulting in the first report of an ongoing pregnancy in Europe. J Assist Reprod Genet 2015;32:12211231. https://doi.org/10.1007/s10815-015-0528-9CrossRefGoogle ScholarPubMed
Prasath, EB, Chan, ML, Wong, WH, et al. First pregnancy and live birth resulting from cryopreserved embryos obtained from in vitro matured oocytes after oophorectomy in an ovarian cancer patient. Hum Reprod 2014;29:276278. https://doi.org/10.1093/humrep/det420Google Scholar
Moravek, MB. Gender-affirming hormone therapy for transgender men. Clin Obstet Gynecol 2018;61:687704. https://doi.org/10.1097/GRF.0000000000000398Google Scholar
Franks, S, Stark, J, Hardy, K. Follicle dynamics and anovulation in polycystic ovary syndrome. Hum Reprod Update 2008;14:367378. https://doi.org/10.1093/humupd/dmn015Google Scholar
Trikudanathan, S. Polycystic ovarian syndrome. Med Clin 2015;99:221235. https://doi.org/10.1016/j.mcna.2014.09.003Google Scholar
Azziz, R. Polycystic ovary syndrome. Obstet Gynecol 2018;132:321336. https://doi.org/10.1097/AOG.0000000000002698Google Scholar
Pache, TD, Chadha, S, Gooren, LJ, et al. Ovarian morphology in long‐term androgen‐treated female to male transsexuals. A human model for the study of polycystic ovarian syndrome? Histopathology 1991;19:445452. https://doi.org/10.1111/j.1365-2559.1991.tb00235.xCrossRefGoogle Scholar
Grynberg, M, Fanchin, R, Dubost, G, et al. Histology of genital tract and breast tissue after long-term testosterone administration in a female-to-male transsexual population. Reprod Biomed Online 2010;20:553558. https://doi.org/10.1016/j.rbmo.2009.12.021Google Scholar
Grimstad, FW, Fowler, KG, New, EP, et al. Ovarian histopathology in transmasculine persons on testosterone: a multicenter case series. J Sex Med 2020;17:18071818. https://doi.org/10.1016/j.jsxm.2020.05.029Google Scholar
Ikeda, K, Baba, T, Noguchi, H, et al. Excessive androgen exposure in female-to-male transsexual persons of reproductive age induces hyperplasia of the ovarian cortex and stroma but not polycystic ovary morphology. Hum Reprod 2013;28:453461. https://doi.org/10.1093/humrep/des385Google Scholar
Caanen, MR, Schouten, NE, Kuijper, EA, et al. Effects of long-term exogenous testosterone administration on ovarian morphology, determined by transvaginal (3D) ultrasound in female-to-male transsexuals. Hum Reprod 2017;32:14571464. https://doi.org/10.1093/humrep/dex098Google Scholar
De Roo, C, Tilleman, K, Vercruysse, C, et al. Texture profile analysis reveals a stiffer ovarian cortex after testosterone therapy: a pilot study. J Assist Reprod Genet 2019;36:18371843. https://doi.org/10.1007/s10815-019-01513-xGoogle Scholar
Jackson-Bey, T, Colina, J, Isenberg, BC, et al. Exposure of human fallopian tube epithelium to elevated testosterone results in alteration of cilia gene expression and beating. Hum Reprod 2020;35:20862096. https://doi.org/10.1093/humrep/deaa157CrossRefGoogle ScholarPubMed
Stenzel, AE, Moysich, KB, Ferrando, CA, Starbuck, KD. Clinical needs for transgender men in the gynecologic oncology setting. Gynecol Oncol 2020 (online). https://doi.org/10.1016/j.ygyno.2020.09.038Google Scholar
Urban, RR, Teng, NN, Kapp, DS. Gynecologic malignancies in female-to-male transgender patients: the need of original gender surveillance. Am J Obstet Gynecol 2011;204:e9e12. https://doi.org/10.1016/j.ajog.2010.12.057Google Scholar
Dizon, DS, Tejada-Berges, T, Koelliker, S, et al. Ovarian cancer associated with testosterone supplementation in a female-to-male transsexual patient. Gynecol Obstet Invest 2006;62:226228. https://doi.org/10.1159/000094097Google Scholar
Hage, JJ, Dekker, JJ, Karim, RB, Verheijen, RH, Bloemena, E. Ovarian cancer in female-to-male transsexuals: report of two cases. Gynecol Oncol 2000;76:413415. https://doi.org/10.1006/gyno.1999.5720CrossRefGoogle ScholarPubMed

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