For years, fertility guidance for transgender men has leaned heavily on egg retrieval and freezing data, with far less known about what happens after — embryo development, transfer, and live birth. A large new study is closing that gap, and the findings are genuinely reassuring.
The Study
Presented at the 81st ASRM Scientific Congress & Expo in October 2025, the research came out of Shady Grove Fertility and US Fertility, led by Dr. Kyle N. Le, a Reproductive Endocrinology and Infertility fellow, with Dr. Phillip Romanski as senior author. It's among the first and largest studies to examine embryo development and transfer outcomes — not just egg retrieval — in transgender men.
Researchers compared 24 transgender men who underwent 27 IVF cycles against 50 cisgender women who underwent 61 IVF cycles as a comparison group.
Embryo development outcomes were comparable between the two groups. Just as notably, among transgender men with a history of testosterone use, live birth outcomes were similar to those without prior testosterone exposure — directly addressing one of the most common questions patients and providers have had about this population.
Transgender men can achieve pregnancy outcomes on par with cisgender women, even with prior testosterone exposure. This gives both patients and providers real evidence-based data to work from, instead of extrapolating from small case reports.
What Earlier Research Had Already Shown
This new study builds on a foundation of smaller studies. A 2023 academic-center review of 77 transgender men found that those who proceeded to fertility treatment achieved an average oocyte maturity rate of about 78% and fertilization rates above 80%, with average embryo grades comparable to typical IVF outcomes. That study also found no correlation between how long a patient had used testosterone (or how long they'd paused it) and the number of eggs retrieved — useful reassurance for men worried that time on hormone therapy would permanently affect their fertility potential.
What the Process Typically Involves
For transgender men pursuing IVF or egg/embryo freezing, treatment generally requires pausing testosterone to allow menstrual cycles to resume before ovarian stimulation can begin. This pause — and the return of a menstrual cycle and associated dysphoria it can bring — is frequently cited as one of the harder parts of the process emotionally, separate from the physical protocol itself.
- Testosterone pause. Typically required to allow ovarian function and menstrual cycling to resume.
- Ovarian stimulation. Standard gonadotropin protocols, similar to any IVF cycle, monitored via bloodwork and ultrasound.
- Egg retrieval. A standard retrieval procedure under sedation.
- Fertilization and embryo development. Using partner or donor sperm, following typical IVF lab protocols.
- Transfer. Embryos can be transferred to a partner, gestational carrier, or the transgender man himself, depending on individual circumstances and goals.
Evidence-based data lets clinics counsel transgender patients from real outcomes, not assumptions.
Why This Data Matters Beyond the Numbers
Historically, transgender patients seeking fertility care have often encountered providers with limited experience treating this population, leading to inconsistent counseling and, in some cases, patients being discouraged from pursuing biological parenthood altogether. Larger studies like this one give clinics a real evidence base to counsel from, which matters for informed consent, for insurance and coverage conversations, and simply for patients being able to make a fully informed decision about their own family-building options.
Not every fertility clinic has deep experience with transgender fertility care. When researching clinics, it's reasonable to directly ask about their experience treating transgender patients, their approach to testosterone pause protocols, and how they handle gender-affirming communication throughout treatment (for example, using chosen names and pronouns consistently in clinical settings).
Exploring Your Family-Building Options?
ConceiveGuide has a full breakdown of transgender fertility protocols and what to expect at each stage.
Read the Clinical Deep Dive →Does testosterone use permanently affect fertility?
Current research suggests testosterone use does not appear to permanently damage ovarian reserve or egg quality in most cases, and cycles typically resume after pausing hormone therapy. Individual results vary, and a fertility specialist can evaluate ovarian reserve directly through bloodwork (AMH) and ultrasound.
Do I have to carry the pregnancy myself?
No. Embryos created through this process can be transferred to a partner, a gestational carrier, or the transgender man himself, depending on individual goals and medical circumstances.