TY - JOUR
T1 - Successful oocyte cryopreservation using letrozole as an adjunct to stimulation in a transgender adolescent after GnRH agonist suppression
AU - Martin, Caitlin E.
AU - Lewis, Christopher
AU - Omurtag, Kenan
N1 - Funding Information:
The authors thank Deborah J. Frank, Ph.D. for editing the manuscript.
Publisher Copyright:
© 2021 American Society for Reproductive Medicine
PY - 2021/8
Y1 - 2021/8
N2 - Objective: To report a successful case of ovarian hyperstimulation and oocyte cryopreservation in a transgender male adolescent after suppression with a gonadotropin-releasing hormone (GnRH) agonist while using the aromatase inhibitor letrozole to maintain low serum estradiol. Design: Case report. Setting: Division of Reproductive Endocrinology and Infertility, Washington University in St. Louis School of Medicine, St Louis, Missouri. Patient(s): A 15-year-old Tanner II transgender male adolescent with a GnRH agonist implant. Intervention(s): The GnRH agonist implant was removed. The patient was given letrozole (5 mg daily) while undergoing ovarian stimulation with an antagonist protocol. After oocyte retrieval, the patient began taking testosterone. Main Outcome Measure(s): Successful oocyte cryopreservation with minimal changes in breast budding. Result(s): The patient's peak serum estradiol concentration was 510 pg/mL. Twenty-two mature oocytes were cryopreserved. Small increases in breast budding occurred between baseline and the time of oocyte retrieval. Conclusion(s): We successfully used letrozole to maintain low serum estradiol in a transgender male adolescent during ovarian stimulation. Maintaining low estradiol to minimize pubertal development and possibly prevent gender dysphoria symptoms may make oocyte cryopreservation more desirable for transgender male adolescents.
AB - Objective: To report a successful case of ovarian hyperstimulation and oocyte cryopreservation in a transgender male adolescent after suppression with a gonadotropin-releasing hormone (GnRH) agonist while using the aromatase inhibitor letrozole to maintain low serum estradiol. Design: Case report. Setting: Division of Reproductive Endocrinology and Infertility, Washington University in St. Louis School of Medicine, St Louis, Missouri. Patient(s): A 15-year-old Tanner II transgender male adolescent with a GnRH agonist implant. Intervention(s): The GnRH agonist implant was removed. The patient was given letrozole (5 mg daily) while undergoing ovarian stimulation with an antagonist protocol. After oocyte retrieval, the patient began taking testosterone. Main Outcome Measure(s): Successful oocyte cryopreservation with minimal changes in breast budding. Result(s): The patient's peak serum estradiol concentration was 510 pg/mL. Twenty-two mature oocytes were cryopreserved. Small increases in breast budding occurred between baseline and the time of oocyte retrieval. Conclusion(s): We successfully used letrozole to maintain low serum estradiol in a transgender male adolescent during ovarian stimulation. Maintaining low estradiol to minimize pubertal development and possibly prevent gender dysphoria symptoms may make oocyte cryopreservation more desirable for transgender male adolescents.
KW - Transgender
KW - aromatase inhibitor
KW - fertility cryopreservation
KW - letrozole
KW - oocyte cryopreservation
KW - transgender male adolescent
UR - http://www.scopus.com/inward/record.url?scp=85103314404&partnerID=8YFLogxK
U2 - 10.1016/j.fertnstert.2021.02.025
DO - 10.1016/j.fertnstert.2021.02.025
M3 - Article
C2 - 33795140
AN - SCOPUS:85103314404
VL - 116
SP - 522
EP - 527
JO - Fertility and Sterility
JF - Fertility and Sterility
SN - 0015-0282
IS - 2
ER -