Fertility preservation advice vital for transgender people

“When my son is older and says to me ‘mum, who is my dad?’ I will tell him the truth and explain that I am his dad, but I am also his mum,” says transgender mum Jamie. “It will be a difficult conversation but there are some things you cannot lie about and hide.” 

Jamie lives with her partner Samantha and their six-month-old son Toby in Cambridgeshire.

Fertility preservation advice

The conversation about fertility preservation happens too late for many transgender individuals.

Jamie says “There doesn’t seem to be that much support for trans people prior to transition with regards to fertility preservation and storing sperm or eggs.

I think the best time for the issue of fertility preservation to be broached is once you have seen the psychiatrist or therapist and before you go to the gender clinic. By the time you get to the gender clinic you just want to get on with taking the hormones and having to make a rushed decision about freezing sperm or eggs would just cause a delay and hold you back.

Trans people, especially if they don’t currently have a partner, will be thinking in the ‘here and now’ but they should consider how they might feel about having a child in ten or twenty years from now.  If the first time this is mentioned is when you attend the gender clinic for your initial appointment this might feel overwhelming –  and it could be too late for many.”

Love at first sight

Jamie and Samantha started trying for a baby before Jamie transitioned.

The couple met four years ago through an online dating site when Jamie was still living as a male. Jamie confided in Samantha that she had sought advice on transitioning from male to female, but it didn’t affect their blossoming relationship and after four months they were living together.

“Things got serious pretty quickly,” says Jamie. “We just clicked on our first date and it felt as though we’d known each other our whole lives.  I have spent my whole life wishing I was born female. It took me a long while to accept it and do something about it and, because I am autistic, I hadn’t quite understood it”.

Like many couples, one of the first things that Samantha and Jamie discussed was the subject of children. “I had always wanted children and we knew that once I transitioned we wouldn’t be able to have them naturally because the hormone therapy stops sperm production,” she says.

fertility preservation advice for transgender couples very important

Fertility difficulties 

The couple started trying for a baby in earnest and assumed that as they were still in their mid-twenties  they wouldn’t have any difficulties conceiving.

Samantha 28 says: “It hadn’t occurred to me that we would have fertility problems, we are both healthy and active and neither of us are overweight or smoke or drink. A lot of my friends had their children quite young and were already on their second or third child. We were both devastated that I wasn’t getting pregnant.  I had been on the mini-pill for a number of years,” she explains “and when I came off it my periods were really irregular. I was told that they would go back to normal but they never did. So that I would know when I was ovulating I was advised by my GP to use ovulation sticks but all the time I used them I never got a full smiley face, just a little one.”

The couple went back to their GP and were referred for hospital tests which revealed that there were issues with both of them which could be affecting their fertility. They were told that they would be eligible for fertility treatment.

Open about transition 

“We went along to an open day at Bourn Hall and were open from the outset about Jamie’s plans to transition,” says Samantha. “They spoke to us about fertility preservation, so as well as the IVF treatment Jamie had the maximum allowed amount of sperm frozen for future use because once her hormone treatment started she wouldn’t have any sperm left.”

At Bourn Hall Samantha and Jamie had IVF using a process called Intracytoplasmic Sperm Injection (ICSI) – which involved individually injecting one of Jamie’s sperm in to each of six eggs harvested from Samantha – before one embryo was transferred to Samantha’s womb.

Fertility preservation of sperm and embryo

A remaining embryo was frozen at Bourn Hall – as well as 22 units of Jamie’s sperm – the maximum allowed – for future IVF treatment should they want it.

The couple were delighted when their IVF treatment worked first time and Samantha vividly remembers their first scan at Bourn Hall. “We saw his little heart fluttering on the screen and we both cried,” she says.

In April 2018 Samantha and Jamie welcomed their son Toby in to the world. “I love being a mum and I cannot put in to words how much I love him,” says Samantha.

Having lived as a woman for two years Jamie is now attending appointments at a gender clinic in London and has been taking female hormones for 8 months.

Two mums 

Toby will call Samantha ‘Mummy’ and Jamie ‘Mum’. His birth certificate lists Jamie as the father under her previous name and Jamie feels no need to change that.

“I don’t feel as though I have to change everything,” she says. “The truth is that I was born male; I wish I wasn’t but I cannot change that part of my life. When Toby asks me where his Dad is I will explain; I am never going to lie to him about who his actual father is because the truth is that I am.”

IVF helped couple become parents before gender transition

Hormonal and surgical treatment for gender dysphoria can impact on fertility. Fertility preservation techniques, such as sperm and egg freezing, before transition, offer the opportunity to create a family through assisted conception in the future.

For more information on the transgender services provided by Bourn Hall Clinic, which has clinics in Cambridge, Norwich, Wickford and Colchester, visit our treatment page here.

Three IVF daughters, successful first time for each

Claire met her husband John through a lonely hearts advert in the ‘Beds on Sunday’ in 1999, before the days of internet dating, and they always assumed that they would have children some day but those dreams were shattered when John was diagnosed with cancer.

Non-Hodgkin Lymphoma

John was diagnosed with non-hodgkins lymphoma and, as treatment with chemotherapy can affect your fertility, he was offered the option of freezing his sperm which he accepted.  After two difficult years which included a stem cell transplant he went in to remission.

Five years later the couple decided to start a family and after fertility testing it was confirmed that they would need IVF treatment. They were offered NHS funding and after some research, chose the world-famous Bourn Hall.

“Like something out of Back to the Future”

John’s sperm had been stored at Hammersmith Hospital and as John didn’t want to risk having the sperm couriered he drove it up to Bourn Hall himself. He says driving with the box of dry ice “was like something out of Back to the Future.”

Delivering the good news

cancer

The first cycle of treatment was successful and the couple broke the news to both sets of prospective grandparents at the same time in a local restaurant.

“We decided to photocopy the baby scan on to the back of the menu and then sat the parents opposite each other. It took them a while to realise and we had to spell it out to them!” laughs Claire. “They were all over the moon – tears, especially John’s parents who had envisaged he would never have a family.”

Sydney, Robynne and Kennedy

Claire gave birth to a little girl, Sydney. It was the first grandchild for Claire’s mum and stepdad and on John’s side it was the first granddaughter.

The couple then went on to have two further IVF babies funding the treatment themselves.  Robynne was born two years after Sydney, and Kennedy, their third daughter, is now 14 weeks old.

Each child was born following their first IVF attempt.

“For all three children we didn’t tell anyone we were having treatment as it took the pressure off,” says John. “With each scan you go up the ladder but the further up the ladder you go you know that you have further to fall and you have to keep your hopes up. We have been so lucky. Parenting is the most challenging and rewarding job.

cancer

“Bourn Hall staff are fantastic”

“Bourn Hall staff are fantastic. They were open and honest and managed expectations. We took Sydney and Robynne when Claire was being treated for Kennedy and they were so delighted to see the fruits of their work. And that was everyone starting from the ladies on reception.”

Claire is now a self-employed dressmaker, which allows her to balance motherhood and work.

“We are so proud of the girls, we have been through so much to get here,” she beams.

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Fertility preservation gives cancer patient hope of parenthood

While losing weight to improve her chances of having a baby, Fiona was devastated to discover a lump in her breast.  To protect her dream of a family, Fiona didn’t hesitate for a second when asked if she wanted to delay her first round of chemotherapy so that she could have some embryos frozen for future fertility treatment.

Chemotherapy affects both female and male fertility: in women it can stop the ovaries from working and can cause an early menopause; in men it can reduce the number of sperm produced or affect the sperm’s ability to fertilise an egg.

Fiona and her partner Ian knew that Fiona’s fertility could be destroyed once she had begun her chemotherapy and were in complete agreement about what to do next.

Delaying chemotherapy

fertility preservation

“I discovered the lump as I started to lose weight as we wanted to start a family, so it was a double kick to find that not only had I got cancer, my chance of having a baby was threatened,” says Fiona. “My consultant said early on that as this was a hormone-led cancer that I had to be pushed into a menopause and that the only way that I could get pregnant was with IVF.

“We both wanted a family and knew that if I started my chemotherapy straight away we might not get the chance to have children at all,” she says.

The specialists treating Fiona for her cancer completely supported her decision to delay chemotherapy and the couple went along to Bourn Hall Clinic in Colchester for tests. Fiona was then given drugs to stimulate her egg production.

“The team at Bourn Hall had to monitor me closely because my cancer was oestrogen-driven and I could be affected by the extra hormones in my body,” Fiona explains.

Fertility preservation

Eight of Fiona’s eggs were harvested and fertilised with Ian’s sperm using a process called ICSI and then frozen for when Fiona is well enough for fertility treatment.

Fiona’s original diagnosis of Stage 3 breast cancer had already resulted in a mastectomy on her left breast followed by reconstructive surgery.

“Within three weeks after egg collection I was receiving chemotherapy and then after three months started the anti-cancer drugs tamoxifen which I had to take for two years and need to have been off it for 6 months before the next IVF stage,” explains Fiona. “During the same time I celebrated turning 40.”

In the last 18 months Bourn Hall Clinic has collected and frozen sperm, embryos or eggs for more than 100 cancer patients before they embarked on a course of chemotherapy.

“Fertility treatment can be a very emotional journey,” says Sarah Pallett, Clinic Manager at Bourn Hall in Colchester, “so to throw the curve-ball of cancer in to the mix makes it even more so. We find that many of the cancer patients who come to us for sperm, embryo or egg freezing get a reassuring sense of asserting some control of one aspect of their life when they might be facing some really tough times ahead.”

Optimistic for the future

Fiona is grateful that the cancer team treating her encouraged her decision to briefly delay her chemotherapy so that her eggs could be collected, fertilised and frozen for her future use.

Fiona has just returned to Bourn Hall Clinic in Colchester with the view to starting her fertility treatment shortly and is looking forward to what may lay ahead:

“We have always held onto the hope of a “normal” life after cancer, and to be blessed with a baby would be the fantastic positive after the hell of last three years, but I am aware that it could be a lot worse,” she says.

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