(Q28929)
Statements
How do transfeminine adolescents and their parents experience fertility preservation via testicular sperm extraction (TESE)? (English)
STUDY QUESTION (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
Participants experienced the TESE process positively when provided with appropriate guidance to navigate the decisional dilemma between preserving future biological parenthood and the pressure to start puberty suppression early. (English)
SUMMARY ANSWER (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
Sperm banking through ejaculation is not feasible for all transfeminine adolescents due to genital dysphoria and early puberty; for this group, TESE is the only alternative. (English)
WHAT IS KNOWN ALREADY (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
However, during early puberty, they must postpone or pause puberty suppression until spermatogenesis is fully developed. (English)
WHAT IS KNOWN ALREADY (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
All consecutive TESE patients in our centre and their parents were invited to participate. (English)
STUDY DESIGN, SIZE, DURATION (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
Between December 2022 and May 2023, we included 6 adolescents and 10 parents. (English)
STUDY DESIGN, SIZE, DURATION (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
We used a qualitative approach based on semi-structured interviews to study the experience of the transfeminine adolescents and their parents. (English)
STUDY DESIGN, SIZE, DURATION (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
Transfeminine adolescents diagnosed with gender dysphoria in early puberty (Tanner stage ≥2) who underwent TESE before the start of puberty suppression or gender-affirming hormones participated in this study. (English)
PARTICIPANTS/MATERIALS, SETTING, METHODS (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
The interviews were recorded, manually transcribed and analysed using reflective thematic analysis focusing on understanding the participants' experiences of puberty and fertility preservation and the various factors and social processes influencing their decision to undergo TESE. (English)
PARTICIPANTS/MATERIALS, SETTING, METHODS (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
Transfeminine adolescents decide to undergo invasive fertility preservation because of a possible, future desire for parenthood. (English)
MAIN RESULTS AND THE ROLE OF CHANCE (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
Parents stressed the importance of preventing future decisional regret. (English)
MAIN RESULTS AND THE ROLE OF CHANCE (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
They both saw masturbation to obtain a semen sample as unreachable. (English)
MAIN RESULTS AND THE ROLE OF CHANCE (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
Even though TESE is a surgical procedure with possible complications and pain afterwards, this alternative seemed less dysphoric to them.Adolescents had to postpone the start of puberty suppression, waiting for spermatogenesis to complete. (English)
MAIN RESULTS AND THE ROLE OF CHANCE (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
Given the unpredictable development of puberty, they felt a lot of stress and anxiety during this period and were primarily concerned about the lowering of their voice. (English)
MAIN RESULTS AND THE ROLE OF CHANCE (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
Because of this puberty-related stress, they were constantly balancing their motivations for fertility preservation against the early start of puberty suppression to prevent unwanted irreversible pubertal body changes. (English)
MAIN RESULTS AND THE ROLE OF CHANCE (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
To support this decisional dilemma, adolescents and their parents need adequate communication with each other and their healthcare providers to reflect on their stress for pubertal change. (English)
MAIN RESULTS AND THE ROLE OF CHANCE (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
Furthermore, close, continuous surveillance of their current mental state by their parents, together with their psychologist and pubertal development by their physicians, is needed. (English)
MAIN RESULTS AND THE ROLE OF CHANCE (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
Despite the challenging decision and postponement of puberty suppression, they retrospectively experienced it positively without any regret. (English)
MAIN RESULTS AND THE ROLE OF CHANCE (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
All adolescents successfully underwent TESE, with viable spermatozoa obtained and without complications. (English)
LIMITATIONS, REASONS FOR CAUTION (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
This may result in a more positive reflective experience regarding fertility preservation. (English)
LIMITATIONS, REASONS FOR CAUTION (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
Furthermore, the perspectives of adolescents with the intention of TESE but who already started with puberty suppression before the preservation were not included. (English)
LIMITATIONS, REASONS FOR CAUTION (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
This study helps healthcare providers improve their counselling and guidance of transfeminine adolescents who consider postponing puberty suppression for fertility preservation via TESE. (English)
WIDER IMPLICATIONS OF THE FINDINGS (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
The adolescents and their parents know more clearly what to expect during fertility preservation. (English)
WIDER IMPLICATIONS OF THE FINDINGS (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
Specific peer-support programs may facilitate the decision process for upcoming adolescents. (English)
WIDER IMPLICATIONS OF THE FINDINGS (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
No external funding was used for this study. (English)
STUDY FUNDING/COMPETING INTEREST(S) (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
None of the authors have any conflicts of interest. (English)
STUDY FUNDING/COMPETING INTEREST(S) (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
Not applicable. (English)
TRIAL REGISTRATION NUMBER (English)
© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. (English)
2024
T H R (English)
Stolk (English)
THR
N M (English)
van Mello (English)
NM
J A F (English)
Huirne (English)
JAF
E (English)
van den Boogaard (English)
E
5 November 2024
4 November 2024
The authors have nothing to declare relevant to this work. (English)