This article is part of a series on the impacts of hormone replacement therapy (HRT), designed to help our clients (and others!) prepare for possible changes they may experience as they begin their hormone journeys.
When preparing for transition, many people are eager to start taking hormones. However, it is important to consider how testosterone may impact your reproductive system, including your ability to become a biological parent in the future.
What are the reproductive system changes caused by estrogen?
The impact of feminizing hormone therapy on fertility is unclear. While some data suggest that stopping hormones for 3-6 months can allow sperm counts to return, it is best to assume that within a few months of starting hormone therapy, you could permanently and irreversibly lose the ability to create sperm. Some people may maintain a sperm count on hormone therapy or have their sperm count return after stopping hormone therapy, but it is best to assume that won’t be the case for you.
If there is any chance you may want to parent a child from your own sperm, speak with your medical provider about preserving your sperm in a sperm bank. This process generally takes 2-4 weeks and costs roughly $2,000-$3,000. It is best to store your sperm before beginning treatment to avoid any risk of reduced sperm count due to hormone therapy. Storing sperm in advance also avoids the stress of having to stop hormones at a later time to allow testosterone levels and sperm counts to come up; often, this involves a return of some masculine characteristics during the time off of hormones.
Feminizing hormone therapy does not always eliminate sperm count, so if you are sexually active with someone who can become pregnant, you should continue to use a birth control method to prevent unwanted pregnancy.
