Fertility and fertility preservation

Some trans men wish to have children. Others do not. The choice is a personal one. If you think you'd like to have children, ask your healthcare professional about the options available to you. No matter what you choose to do, it's a good idea to plan ahead. If possible, make decisions about children before you start hormone therapy or have gender-affirming surgery.

If you have a uterus and ovaries, you can get pregnant if you have vaginal sex with a person who can produce sperm. This is true even if you take testosterone or have irregular menstrual cycles or no menstrual cycles. Although testosterone might lessen your chance of pregnancy, don't rely on testosterone therapy for birth control. Pregnancy remains possible until menopause.

Birth control options include:

• Barrier methods. Condoms and other barrier forms of birth control help prevent pregnancy and sexually transmitted infections.
• Intrauterine device (IUD). An IUD that contains the hormone progestin (Mirena, Liletta, Skyla) can serve as birth control and decrease menstrual bleeding.
• Hormone birth control. Many trans men prefer not to take estrogen. But progestin-based pills are an option for those who would like a pill form of birth control.
• Permanent birth control. Permanent birth control options include tubal ligation, a surgery that permanently blocks the fallopian tubes, and complete removal of the fallopian tubes, a procedure called salpingectomy.

If you want to become pregnant, talk to your healthcare professional. If you take testosterone, you'll need to stop. Talk to your healthcare professional about how hormone use may affect your fertility. Procedures are available that make it possible to carry a pregnancy or to collect and freeze unfertilized eggs or ovarian tissue for future use. This might involve medicine or surgery. Typically, these procedures are available at specialized fertility centers. They can be expensive.