Freezing gametes or tissue for future use

You can be referred to the fertility specialist to discuss the options of preserving fertility while hormone therapy. This will involve collecting reproductive cells and storing them at very low temperatures. Based on your circumstances, the consultant will discuss and advise treatment that is appropriate for you. This might include:

• collecting and freezing gametes or
• gonad tissue cryopreservation

We are here to support you, and will be happy to answer any questions you have.

We'll give you personalised guidance based on your circumstances, to help you make informed decisions and explore the most suitable options for preserving fertility.

Before fertility preservation treatment

Before we can store your samples, you have a consultation with a doctor or nurse in the fertility unit to talk about storing your gametes, and to complete the relevant consent forms. We'll ask you to complete consent forms, have a ultrasound scan on your tummy, and have a blood test.

Tests for HIV and hepatitis

In theory, there’s a risk of viral cross-contamination between samples that are stored in liquid nitrogen.

There has never been a report of this happening but, because of the theoretical risk, you must be screened for HIV and hepatitis B and C.

We cannot freeze any samples until we’ve had the results of these tests.

Our assisted conception unit currently cannot offer storage if you test positive for HIV or hepatitis B or C at this time, but we will be able to advise where this service is available.

Collecting gametes

The process of freezing reproductive cells (gametes) is generally completed in 14 to 18 days.

We recover and store your gametes after 10 to 14 days of daily injections used to stimulate your gonads. 

To monitor your response to hormonal stimulation before we retrieve your gametes, we might ask you to come to the unit once or twice for a tummy scan. This is non-invasive, but does require a full bladder to get the best image possible.

We stimulate the gonads with daily hormone injections to produce several gametes, which are then recovered during a minor procedure.

There is no specific number of gametes that can be retrieved that will definitely result in a successful pregnancy. You should also be prepared that, even if response to stimulation is adequate, there might be no gametes to be collected. However, this rarely happens. 

Procedure to recover your gametes

Gamete retrieval is done under deep sedation (when you're given medicine to make you drowsy).

We prefer to retrieve the gametes through the front hole (vagina), as it's the most safe and efficient. This approach is minimally invasive because we use small probes. However, we can also retrieve gametes through the tummy.

Gamete freezing and future use

Your gametes are stored at a very low temperature.

In the future, when you want to proceed with fertility treatment, the gametes will be thawed out and mixed with sperm, from a biologically assigned male partner or donor, to create embryos.

These embryos could be transferred to the womb of a surrogate, a biologically assigned female partner or yourself, if this option is appropriate in your case.

Survival of frozen gametes

The survival of frozen unfertilised eggs is good. Occasionally some of them do not tolerate the freezing and thawing process. The chances of pregnancy using frozen eggs are slightly reduced compared to frozen embryos (eggs successfully fertilised with sperm). However, these techniques are constantly improving, and the latest report from HFEA showed that live birth rate from frozen eggs was only 3% less than from frozen embryos.

Success rate with frozen gametes

Your individual chances will be explained to you by a doctor, once the clinical assessment has been done.

Data for long-term outcomes from frozen eggs remains limited for transgender patients. However, the most important factors that influence overall success are your age when eggs are collected and frozen, and the total number of eggs frozen. Collecting eggs under the age of 35 will give a significant advantage for the biological quality of eggs and future outcomes.

Side effects and complications

During stimulation, the developing gametes will produce oestrogen that may temporarily affect your mood. You might be feeling bloated, especially a couple of days before or after the treatment. You might also feel engorgement and tenderness in your chest. These symptoms are not permanent and will get better shortly after the process has finished.

There is a small chance of over responding to the medicines. This is known as ovarian hyperstimulation syndrome (OHSS). 

Although egg retrieval is a minimally invasive procedure, it could result in complications including:

• internal bleeding
• damage to the surrounding organs
• infection

Based on your medical history, your doctor can advise you and plan to avoid this happening.

A couple of days after the procedure, you might also have some spotting, and feel bloated and sore. 1 to 2 weeks later, you might have vaginal bleeding that might be heavy. Our team can offer advice about any concerns you have.

Your doctor can give you more information about these complications.

It's important to remember that any cycle of fertility preservation can be cancelled if there is a medical reason.

Gonad tissue cryopreservation

This is when the surgeon removes a small piece of gonad tissue and freezes it. The operation is done under general anaesthetic, which means that you will be deeply unconscious for the whole procedure.

During the procedure, the surgeon inserts a laparoscope (small camera) into your tummy (abdomen) to guide them while they remove the tissue.

The tissue is then frozen, and at a later date, the tissue can be transplanted back into your body.

Although commonly used in the care of cancer patients, this procedure is not established for transgender patients. Our doctors can give you more information about this.

Currently, there is also no NHS funding for this type of treatment.