NHS Should Offer Transgender Men Fertility Preservation So They Can Become Parents, Advises British Fertility Society | HuffPost Life

'It is hugely frustrating that the NHS is not always able to help our patients.'

By

Life editor at HuffPost UK

Transgender men should be offered egg storage on the NHS, the British Fertility Society (BFS) has suggested in new guidelines.

Many Clinical Commissioning Groups (CCGS) don’t fund fertility preservation for transgender people, but the BFS believes they should, as transgender people have the right to become parents.

Today (4 January), at the Fertility 2018 meeting in Liverpool, the BFS will present these guidelines urging the NHS to offer fertility preservation for transgender people assigned female at birth.

“The number of people coming forward with gender dysphoria has increased rapidly over the past decade, but the consistent provision of NHS funding for fertility preservation for this group has yet to catch up,” said Dr James Barrett, of Charing Cross Hospital’s Gender Identity Clinic.

MidoSemsem via Getty Images

Dr Barrett is presenting at Fertility 2018 on fertility preservation for transgender people.

“My clinic sees around half of the patients being referred for difficulties with gender identity in the UK,” he said. “Although we do discuss future fertility with them, they are not always able to self-fund for the necessary procedures and ongoing storage of material,” he said.

“Infertility is a real disease and it is hugely frustrating that the whole NHS is not always able to help our patients with that part of their lives.”

Dr Barrett explained that for transgender people, medical interventions, such as hormone treatment and surgery, may be necessary, but can reduce or destroy fertility.

However, by freezing eggs, embryos, or ovarian tissue, there is still the opportunity for transgender men to have a child who is biologically related to them, through pregnancy or surrogacy.

Commenting on the introduction of the new guidelines, Professor Adam Balen, chair of the BFS said: “There are a number of situations where the preservation of fertility is needed. This has to happen at a time before a person is ready to start a family and can sometimes be the only hope for becoming a parent in the future.

“Our guidelines are designed to help our members and the wider fertility community to decide on the best course of treatment, in consultation with these patients.”

The new guidelines also introduce the need for fertility preservation for women undergoing cancer treatment - as the medicine that cures them can also render them infertile - and genetic, congenital and other conditions that may leave a person infertile.

In 2013 NICE (the National Institute for Health and Care Excellence) updated guidance on fertility, including a recommendation that the criteria for NHS fertility treatment should not apply to women seeking fertility preservation, and that no lower age limit should be used.

In reality, the BFS said the provision of fertility preservation treatment is patchy, with local CCGs deciding on their own criteria. The same can be said for fertility treatment, for which there is a “postcode lottery” of care, it was revealed in October 2017.

For more information on the BFS’ new guidelines, click here.

Before You Go

10 Things You May Not Know About Your Fertility

(01 of10)

1. Your fertility is mostly determined by genetics, which influences how many eggs you are born with. Doctors believe that the number of eggs you have at birth determines the length of time you will remain fertile. At birth, women have about two million eggs in their ovaries. For every egg ovulated during your reproductive life, about 1,000 eggs undergo programmed cell death. Other things, such as smoking cigarettes and certain types of chemotherapy, can accelerate egg cell death and promote an earlier menopause.

(02 of10)

2. Regular menstrual cycles are a sign of regular ovulation.Most women have regular cycles lasting between 24 and 35 days. This is usually a sign of regular, predictable ovulation. Women who do not ovulate regularly have irregular menstrual cycles. Those who do not ovulate at all may have a genetic condition called polycystic ovarian syndrome (PCOS).

(03 of10)

3. Basal temperature charting does not predict ovulation.An older method of tracking ovulation involves taking your oral body temperature each morning before getting out of bed. This is called basal body temperature. This method is used to spot a rise in basal temperature, which is a sign that progesterone is being produced. The main problem with using this method is that your temperature rises after ovulation has already occurred. This makes it more difficult to time intercourse at an optimal time for conception. A better method is to use over-the-counter urine ovulation predictor test kits such as Clearblue Easy. These kits test for the hormone that prompts ovulation, which is called luteinizing hormone (LH).

(04 of10)

4. Most women with blocked fallopian tubes are completely unaware they may have had a prior pelvic infection.About 10 percent of infertility cases are due to tubal disease, either complete blockage or pelvic scarring causing tubal malfunction. One major cause of tubal disease is a prior pelvic infection from a sexually transmitted disease such as chlamydia. These infections can cause so few symptoms that you may be completely unaware your tubes are affected. This is why fertility physicians will order a dye test of the tubes, called a hysterosalpingogram (HSG), if you have been trying and failing to conceive for 6 months or longer.

(05 of10)

5. In most cases, stress does not cause infertility. Except in rare cases of extreme physical or emotional distress, women will keep ovulating regularly. Conceiving while on vacation is likely less about relaxation than about coincidence and good timing of sex.

(06 of10)

6. By age 44, most women are infertile, even if they are still ovulating regularly. Even with significant fertility treatment, rates of conception are very low after age 43. Most women who conceive in their mid-40s with fertility treatment are using donated eggs from younger women.

(07 of10)

7. Having fathered a pregnancy in the past does not guarantee fertility. Sperm counts can change quite a bit with time, so never assume that a prior pregnancy guarantees fertile sperm. Obtaining a semen analysis is the only way to be sure the sperm are still healthy!

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8. For the most part, diet has little or nothing to do with fertility. Despite popular press, there is little scientific data showing that a particular diet or food promotes fertility. One limited study did suggest a Mediterranean diet with olive oil, fish and legumes may help promote fertility.

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9. Vitamin D may improve results of fertility treatments. A recent study from the University of Southern California suggested that women who were undergoing fertility treatments, but had low vitamin D levels, might have lower rates of conception. This vitamin is also essential during pregnancy. At Pacific Fertility Center, we recommend our patients take 2,000-4,000 IU per day.

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10. Being either underweight or overweight is clearly linked with lowered levels of fertility. The evidence in recent years is that obesity is clearly linked with a longer time to conception. Having a body mass index less than 18 or over 32 is associated with problems ovulating and conceiving, as well as problems during pregnancy.

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