It explains the different ways fertility can be preserved, what the process involves, possible risks, and how long stored samples can be kept. It also includes information on consent and potential funding.
When to consider fertility preservation
Fertility preservation is best thought about before starting any gender-affirming medical treatment that could reduce your ability to have biological children in the future. Some treatments, such as hormone therapy or certain types of surgery, can lower the number and quality of reproductive cells, or stop their production altogether.
If you have already begun hormone treatment, fertility may start to decline within a few months. In some cases, this change can be permanent. It may still be possible to preserve fertility, but you might need to pause your hormone treatment for a period of time. The length of time needed varies from person to person and should be discussed with your clinical team, who can also help you understand any possible effects on your health and wellbeing.
How fertility preservation works
Preserving fertility involves collecting and storing reproductive cells so they can be used in the future for fertility treatment if you wish to have biological children.
For trans women and non-binary people who were assigned male at birth, this usually means producing a sample that contains reproductive cells, which is then prepared, frozen, and stored at very low temperatures. This process is called cryopreservation and allows the cells to be kept for many years without significant loss of quality.
When you are ready to use your stored sample, it can be thawed and used in assisted reproduction techniques, such as in vitro fertilisation (IVF) or intracytoplasmic injection (ICSI), depending on your individual circumstances.
Before you start
Before beginning fertility preservation, you will have a video consultation appointment to discuss your options, the steps involved, and whether this is the right choice for you.
At this stage, you will be asked about your medical history and any current treatments.
It’s also important to think about your wishes for how the stored material could be used in the future. You will be asked to complete consent forms that explain how your samples can be used, and what should happen to them if your circumstances change. You can update or withdraw your consent at any time. Blood tests will also be needed to check for infections such as HIV, hepatitis B, and hepatitis C, as well as other tests to assess your reproductive health.
If you are currently taking gender-affirming hormones, you may need to pause them before the process can begin. Your healthcare team will explain how long this should be for, and what effects you might experience during this time.
What happens during the process
You will be offered a private space at the clinic to produce a sample for storage. For most people, this is done through self-collection at the clinic. If you think this might be difficult or distressing, let the clinic team know in advance — other collection options may be available and can be discussed with you.
Once your sample is collected, it is checked in the laboratory to assess the number and quality of reproductive cells. If suitable, it will be divided into small portions, frozen, and stored in liquid nitrogen at very low temperatures.
In some cases, if it is not possible to produce a sample in the usual way, a minor surgical procedure may be offered to collect reproductive tissue directly. Your clinical team will explain if this is an option for you.
Risks and limitations
• Not all reproductive cells survive the freezing and thawing process.
• The quality of the sample may vary, and this can affect the chances of success in future fertility treatment.
• There is no guarantee that stored samples will result in a pregnancy.
• Very rarely, technical problems may damage or destroy stored samples.
• If you need to pause gender-affirming hormone treatment before preservation, you may experience temporary physical or emotional effects during that time.
How long samples can be stored
In the UK, reproductive material can usually be stored for up to 55 years, provided you renew your consent at least every 10 years. You can choose to store it for a shorter time if you prefer.
The clinic will contact you before your consent period is due to end, to confirm whether you want storage to continue. If consent is not renewed, the stored material will be removed from storage and disposed of in line with your instructions.
Consent
Before any samples are stored, you will be asked to complete detailed consent forms. These allow you to decide:
• How your stored material can be used in the future.
• Whether it can be used after your death or if you lose the ability to make decisions for yourself.
• Whether it can be used by a partner, if you have one.
• How long you want the material to be stored.
You can change or withdraw your consent at any time, as long as the material has not yet been used in treatment. If you decide to withdraw consent, the material will be removed from storage and disposed of in line with your wishes.
Funding
Fertility preservation may be funded by the NHS if it is required before gender-affirming treatment that is expected to affect fertility. The criteria for NHS funding can vary depending on where you live. Your healthcare team can explain the local arrangements and whether you are eligible.
If you do not meet the criteria for NHS funding, you can still choose to have fertility preservation as a self-funded treatment. The clinic can provide details of the costs for storage and any future use in treatment.
Using your stored samples in the future
When you decide you would like to use your stored material, it can be thawed and prepared for fertility treatment. The most suitable treatment will depend on the quality of the sample and your individual circumstances.
In many cases, stored material can be used in assisted reproduction techniques such as in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI). Your fertility specialist will discuss the options available to you and the likely chances of success.
Support
Thinking about fertility preservation as part of your gender-affirming journey can feel complex and sometimes overwhelming. You may have questions about the process, the emotional impact, or how it fits into your transition plans.
Specialist fertility counselling is available, and you can access this before, during, or after the preservation process. Counsellors can help you explore your feelings, understand your options, and make decisions that feel right for you.
You may also find support and information from:
• Fertility Network UK – www.fertilitynetworkuk.org
• LGBT Foundation – www.lgbt.foundation
• Gendered Intelligence – www.genderedintelligence.co.uk
Contact information
For more information or to arrange an appointment, please contact:
Newcastle Fertility Centre
Newcastle upon Tyne Hospitals NHS Foundation Trust
Telephone: 0191 213 8213 (Monday to Friday, 8am–4:30pm)
Email: nuth.fertilitynurse@nhs.net
