Abstract:
Objective. To measure spermatogenesis abnormalities in transwomen at the time of sex reassignment surgery (SRS) and to analyze
the association between hormonal therapy duration and infertility severity. Design. Retrospective study. Setting. University hospital.
Patients. One-hundred seventy-three transwomen who underwent SRS from January 2000 to December 2015. Interventions.
All orchidectomy specimens were retrospectively reviewed and classifed. History of hormonal therapy duration was retrieved
from medical records. Main Outcome Measures. Histological examinations of orchidectomy specimens were performed to assess
spermatogenesis. Results. One-hundred seventy-three orchidectomy specimens were evaluated. Histological examinations showed
maturation arrest in 36.4%, hypospermatogenesis in 26%, Sertoli cell-only syndrome in 20.2%, normal spermatogenesis in 11%,
and seminiferous tubule hyalinization in 6.4% of the specimens. Spermatogenesis abnormality severity was not associated with the
total therapy duration (P = 0.81) or patient age at the time of surgery (P = 0.88). Testicular volumes and sizes were associated with
spermatogenesis abnormality severity (P = 0.001 and P = 0.026, right testicle and lef testicle, resp.). Conclusion(s). Feminizing
hormonal treatment leads to reductions in testicular germ cell levels. All transwomen should be warned about this consequence,
and gamete preservation should be ofered before starting hormonal treatment.
