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All About Trans Fertility – What you Need To Know

Trans Fertility - What You Need to Know

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Transitioning your gender shouldn’t mean you have to give up on your dream of having a family. Here we’ll break down the basics of trans-fertility and share some helpful signposting to communities and charities that can help you on your journey.

Trans Healthcare and Fertility

If you are struggling with gender dysphoria there are treatments available to help you transition to the gender you feel more aligned with. Many of these treatments will impact your fertility.

One of the most common treatments for the initial stages of transition is hormone therapy. This will mean trans-women will take the female sex hormone oestrogen to help them transition from male to female and trans-men will take testosterone to help them transition from female to male.

Taking these hormones can have an impact on your ‘original’ sex hormones and suppress your fertility, over time it could lead to a complete loss of fertility. Generally speaking, the longer you are on hormone therapy the more likely it is to impact your fertility. Some people do find that if they stop taking hormones their fertility is restored – but that isn’t guaranteed.

If you think you would like biological children in the future, it is possible to preserve your eggs or sperm, or create frozen embryos to be used at a later date, before beginning hormone therapy.

Trans Fertility Preservation

If you have already gone through puberty, it’s possible to freeze your sperm or eggs and store them until you are ready to start your family.
Egg freezing involves an egg collection similar to the process that happens during IVF. It’s a pretty safe and simple procedure although the drugs involved can put you at risk of ovarian hyperstimulation. Freezing sperm is an even easier process! You would simply produce a sample into a cup at your clinic and they would store it for you until you wanted to use it.
If you were unable to produce a sample or felt uncomfortable doing so, there is also the option to have a small surgery known as a sperm extraction, which can take sperm cells directly from the testicles.

For those who haven’t gone through puberty, you will likely not be producing mature eggs or sperm cells, but there are still ways you can preserve your fertility. If you are thinking about starting puberty-suppressing medication or hormone therapy it’s possible for you to store your ovarian or testicular tissue. However, there is no guarantee this will work as fertility treatments using tissue rather than sperm or egg cells are still very experimental. (We’ll go into more detail about this later.)

Sadly, like many fertility treatments, fertility preservation for trans people is not always funded by the NHS. It all depends on where you live and the rules and regulations in the area’s CCG.

Trans Conception

Once you are in a position where you want to try for children, there are a few different options – and they all depend on your unique situation.

If you are a trans-man who was born with a female reproductive system and has not undergone a hysterectomy, it is theoretically possible to conceive with your frozen eggs and donor sperm (or sperm of your partner) and even carry your baby yourself. This is what trans-activist Danny Wakefield did – his story is an inspiring one to follow!

As a trans-man who has had a hysterectomy, you would have to either use a surrogate or have a partner who was able to carry the baby – but you could still potentially use your frozen eggs so the baby would have a biological link to you!

If you are a trans-woman who froze sperm cells before transitioning then you can use those sperm cells in IVF with the eggs of either a donor or a partner and then either a surrogate or your partner could carry the baby.

Again, funding for IVF and assisted fertility treatments for trans people can differ greatly depending on where you live – as can the rules on surrogacy.

In Vitro Gametogenesis and Trans Fertility

In vitro gametogenesis or IVG is a developing technology that could add a whole new dimension to trans-fertility options.

Defining in vitro gametogenesis (IVG), it is the means of developing gametes—reproductive cells like sperm or eggs—outside of the body. In theory, doctors could take any cell from your blood, skin or hair, and manipulate it in a lab to become a gamete. This could then be used to create fertilised embryos that could be used in traditional IVF.

This process is yet to be tested on humans, but recent animal studies have indicated great promise in this medical development.

IVG could be a game changer for trans people and queer couples where both produce the same sex cells. It could mean that not only is it possible to create gametes after a transition has happened (and even potentially negate the need for fertility preservation) but it could also mean that children born from the couple could have both of their genetics! However, many scientists believe we are still 10-20 years away from the first IVG baby

Trans Support Resources

If you are looking for advice and support around your Trans Fertility Journey – here are some resources that might be helpful.

Trans Fertility.Co
Human Fertilisation and Embryology Authority
The Beaumont Society
Gendered Intelligence

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Wearing tight pants and underwear

Studies show that men who wear looser underwear have higher sperm concentration and total sperm count compared to men who wear tighter underwear. So, lose the tight clothes and wear something loose to give your testicles some air.

CONCLUSION: learn more about how heat can affect sperm quality here.


Besides higher mortality rate and various diseases, stress is associated with low sperm quality. Stress is known to be associated with lower testosterone levels and oxidative stress with both playing an essential role in producing and maintaining healthy sperm cells.

CONCLUSION: If you feel stressed, we recommend you get some help so you can have a balanced mental health. For a stress management guide, download the ExSeed app for free and start your personalized action plan today.

Physical activity

Scientific studies show that men who are physically active have better semen parameters than men who are inactive. Fertility specialists also state that regular physical activity has beneficial impact on sperm fertility parameters and such a lifestyle can enhance the fertility status of men.

Prioritizing exercise can help improve your overall health and result in healthy, fast swimming sperm cells that have good chances of fertilizing an egg.

CONCLUSION: Try incorporating exercise in your weekly schedule to you ensure exercising at least twice weekly. We recommend a combination of cardio training and strength exercise. Read more about exercise and male fertility on our blog.


Fast Food
Processed foods damage the health of sperm-producing cells and cause oxidative stress, which lead to poorer sperm quality. Heavy consumption of junk food (every week) can increase the likelihood of infertility since men who consume vast amounts of unhealthy food are at risk of having poor sperm quality. Besides harming your fertility, junk food enlarges your waistline, harms your cardiovascular system, kidneys, and more.

Eating more fruit and vegetables can increase your sperm concentration and motility. It’s important that you consume a healthy diet filled with antioxidants and that you eat vegetables every day. Foods such as apricots and red bell peppers are high in vitamin A, which improves male fertility by nurturing healthier sperm. Men who are deficient in this vitamin tend to have slow and sluggish sperm.

Sugary snacks/beverages: several times a week Excessive consumption of high sugar items can lead to oxidative stress, which negatively impacts testosterone levels and sperm motility. Sugary snacks and beverages are also highly associated with obesity and low fertility.
CONCLUSION: To boost sperm quality, stay away from fast food, processed food, and sugary snacks or beverages. You need to implement a healthy prudent diet filled with necessary superfoods needed for good sperm production. Check out our guide to Male Fertility Superfoods. For personalized guidance and support on how you can start improving your sperm health, check out the Bootcamp.


Direct heat can inhibit optimal sperm production and cause Sperm DNA damage. Sperm cells like environments that are a couple of degrees lower than body temperature. Avoid overheating from warm blankets, seat warmers, heat from your laptop, hot showers, and saunas.

Cigarette smoking

The exposure to tobacco smoke has significant negative effects on semen quality. The damage of cigarettes and nicotine of course depends on how many cigarettes you smoke per day and for how long, but even low usage (up to 10 cigarettes / day) can inhibit healthy sperm production.  

CONCLUSION: Stay as far away from cigarette smoking as possible if you care about your general health and your fertility. Read more here.

Cell phone

When you have your cell phone in your front pocket, your testicles are exposed to electromagnetic radiation, which studies have shown to damage the sperm cells. Put your phone in the back pocket of your pants or in your jacket pocket.


There is a clear association between obesity and reduced sperm quality. At least part of the reason for this is that obese men may have abnormal reproductive hormonal profiles, which can impair sperm production and lead to infertility. 

A BMI higher than 30 can lead to several processes in the body (overheating, increase in oxidative stress in the testes, sperm DNA damage, erectile dysfunction) that can have a negative impact on male fertility. This can result in problems when trying to conceive.  

CONCLUSION: BMI is one of the risk factors that influence semen quality and, for example, sperm motility.  


A beer or glass of wine now and then do not really harm sperm quality. But excess alcohol drinking (more than 20 units per week) can reduce the production of normally formed sperm needed for a successful pregnancy.

CONCLUSION: If you want to stay safe, stay under 14 units of alcohol per week. For more information on how alcohol can affect male fertility, take a look at our blog: “Alcohol and Sperm Quality”.


Studies show that women younger than 35 and men younger than 40 have a better chance of getting pregnant. Men can produce sperm cells almost through their entire life, but the sperm cell DNA is more fragile and prone to damage after the age of 40.

As men age, their testes tend to get smaller and softer resulting in a decline in sperm quality and production. These changes are partly because of an age-related decrease in testosterone level, which plays a very important role in sperm

production. Higher male age (>40 years) is not only associated with a decline in sperm production but also with increased sperm DNA fragmentation and worsened morphology (shape) and motility (movement). These negative effects make the sperm cells less qualified for egg fertilization.

CONCLUSION: with an age under 40, you shouldn’t have to worry much about age as a factor in itself. However, studies have shown a slow decline after the age of 30-35 years

and if you are above 40 years of age, your sperm quality can be affected due to increased sperm DNA damage resulting in a decrease of sperm motility and concentration. Remember that you cannot evaluate the quality of a sperm sample by just looking at it – this requires a sperm analysis.