Fertility preservation is an option available for those who wish to store their eggs, sperm, embryos or tissue for future use in an attempt to have a chance at having a baby. There are several circumstances when one may need to consider this.

We offer fertility preservation facility at our centre. Some of the indications to consider fertility preservation are:

1. Those undergoing cancer treatment that put them at risk of becoming infertile
2. Those who may be at risk of becoming infertile due to treatment for some benign conditions
3. Those considering gender transitioning
4. Elective social egg freezing: Those who wish to electively delay fertility but minimise risk of biological clock ticking.

Sperm freezing

We offer a sperm storage facility to help preserve fertility for men undergoing treatment for cancer and gender transitioning.

We work closely with our cancer specialist colleagues at the Northern Centre for Cancer Care, to provide a fertility preservation service for men undergoing cancer treatment. Advances in treatment mean that more men are now surviving cancer. Some cancer treatments may affect sperm production and fertility in the future. Our sperm storage facility is available for men undergoing such treatment.

Some samples may have to be produced and stored at very short notice. We cannot take self-referrals, your hospital specialist or GP can contact us to ensure that arrangements are made promptly.

Fertility Preservation for Trans Women and Non-Binary People

This information is for trans women and non-binary people who were assigned male at birth and are thinking about preserving their fertility before starting or continuing treatments that could affect their ability to have biological children in the future. These treatments may include gender-affirming hormone therapy or some types of gender-affirming surgery.

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.

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: [email protected]

Egg freezing

We offer an egg storage facility to help preserve fertility for women undergoing treatment for cancer, social egg freezing and gender transitioning. We also offer egg freezing for women with certain benign gynaecological or genetic conditions that may render them infertile.

For referrals for women who wish to discuss fertility preservation, your hospital specialist or GP can make an urgent appointment by ringing or emailing the centre. Less urgent cases should be referred to our Young Persons’ Clinic.

Fertility Preservation for Trans Men and Non-Binary People

This information is for trans men and non-binary people who were assigned female at birth and are thinking about preserving their fertility before starting or continuing treatments that could affect their ability to have biological children in the future. These treatments may include gender-affirming hormone therapy or some types of gender-affirming surgery.

It explains the different ways fertility can be preserved, what the process involves, possible risks, and how long stored eggs or embryos can be kept. It also includes information on consent and potential funding.

When to consider fertility preservation

Fertility preservation is best considered before starting any gender-affirming medical treatment that could reduce your ability to have biological children in the future. Some treatments, such as testosterone therapy or certain types of surgery, can reduce the number and quality of eggs, or stop ovulation altogether.

If you have already begun hormone treatment, fertility can start to decline within a few months. In some cases, these changes may be permanent. It may still be possible to preserve fertility, but you might need to pause hormone treatment for a period of time. The length of time required varies from person to person and should be discussed with your clinical team, who can help you understand the potential effects on your health and wellbeing.

How fertility preservation works

Fertility preservation for trans men and non-binary people who were assigned female at birth usually involves either:

• Egg freezing – eggs are collected from the ovaries after a course of hormonal stimulation and then frozen for future use.
• Embryo freezing – eggs are collected, fertilised with sperm in a laboratory to create embryos, and then frozen.

The freezing process is called cryopreservation and allows eggs or embryos to be stored for many years without significant loss of quality.

When you are ready to use them, the frozen eggs can be thawed and fertilised in a laboratory, or the frozen embryos can be thawed and transferred to the uterus as part of fertility treatment such as in vitro fertilisation (IVF).

Before you start

Before beginning fertility preservation, you will have a video consultation appointment to talk through your options, the steps involved, and whether this approach is right for you.

You will be asked about your medical history and any treatments you are currently having.

It’s also important to think about how you want your stored eggs or embryos to be used in the future.

If you would like to explore this further we will arrange an ultrasound scan and blood tests to check for egg reserve and infections such as HIV, hepatitis B, and hepatitis C.

You will be asked to complete consent forms, which cover how they can be used and what should happen if your circumstances change. You can change or withdraw your consent at any time.

If you are taking testosterone, you may need to pause treatment before starting ovarian stimulation. Your healthcare team will explain how long this should be for and discuss any physical or emotional effects you might experience during that time.

What happens during the process

The first stage is ovarian stimulation. You will take hormone injections for around two weeks to encourage your ovaries to produce multiple mature eggs. During this time, you will have ultrasound scans and sometimes blood tests to monitor your response.

When the eggs are ready to be collected, a short procedure is carried out under sedation or anaesthetic. A fine needle is passed through the vaginal wall, guided by ultrasound, to collect the eggs from the ovaries.

If you are freezing eggs, they will be prepared and frozen soon after collection. If you are freezing embryos, the eggs will be fertilised with sperm in the laboratory before being frozen.

Risks and limitations

• Not all eggs or embryos survive the freezing and thawing process.
• The quality of eggs or embryos may vary, and this can affect the chances of success in future fertility treatment.
• There is no guarantee that stored eggs or embryos will result in a pregnancy.
• Ovarian stimulation can cause side effects such as bloating, discomfort, or mood changes.
• In rare cases, ovarian hyperstimulation syndrome (OHSS) can occur, which may require medical attention.
• Pausing testosterone before treatment may cause temporary physical or emotional effects.

How long eggs or embryos can be stored

In the UK, eggs and embryos can usually be stored for up to 55 years, provided you renew your consent at least every 10 years. You can choose to store them 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 eggs or embryos will be removed from storage and disposed of according to your instructions.

Before any eggs or embryos are stored, you will be asked to complete detailed consent forms. These allow you to decide:

• How your stored eggs or embryos can be used in the future.
• Whether they can be used after your death or if you lose the ability to make decisions for yourself.
• Whether they can be used by a partner, if you have one.
• How long you want them to be stored.

You can change or withdraw your consent at any time, as long as the eggs or embryos have not yet been used in treatment. If you withdraw consent, they will be removed from storage and disposed of according to your wishes.

Funding

Using your stored eggs or embryos in the future

When you decide you would like to use your stored eggs or embryos, they can be thawed and prepared for fertility treatment. The most suitable treatment will depend on your individual circumstances and the quality of the eggs or embryos after thawing.

Frozen eggs are usually fertilised in a laboratory to create embryos, which can then be transferred to a uterus. Frozen embryos can be thawed and transferred directly. Your fertility specialist will discuss the options with you and explain the likely chances of success.

Support

Fertility preservation as part of your gender-affirming journey can bring up a range of emotions and questions. You may be thinking about how the process fits with your transition plans, or you may have concerns about pausing hormone therapy.

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: [email protected]

Embryo freezing

We offer an embryo storage facility to help preserve fertility for some women undergoing treatment for cancer and other conditions if they are in stable relationship with a male partner after appropriate implications counselling.

Other types of referrals

We offer a referral service in collaboration with other centres to consider freezing of ovarian tissue to help preserve fertility for young girls and adolescents undergoing treatment for cancer if they are too young to go through an egg storage process.

For referrals for these young persons and their guardians who wish to discuss fertility preservation, your hospital onco-specialist or GP can make an urgent appointment by ringing or emailing the centre. Less urgent cases should be referred to our Young Persons’ Clinic.

Further information can be found on the HFEA website.