146 Chapter 8 Figure 4. Counselling about fertility preservation, attempted fertility preservation, and successful fertility preservation (sperm suitable for IUI or ICSI preserved) among 35 transgirls ICSI refers to intracytoplasmic sperm injection; IUI refers to intrauterine insemination. Given reasons for not wanting to be referred for FP were (some of the transgirls gave more than one reason) not wanting to have children (17%, n = 4), wanting to adopt (13%, n = 3, one specifically said she did not want to have children who would be like her), feeling uncomfortable with masturbation or having an aversion of their penis (17%, n = 4), and feeling uncomfortable with the idea of being the biological father of the child (4%, n = 1). Eight persons (33%) did not give a specific reason for declining FP. Eight adolescents (33%) were not referred for FP because they were in early puberty and were not able to produce a semen sample through masturbation. The mean age at the start of treatment with GnRHa in the group of transgirls who attempted FP was significantly higher (age 16.1 years ± 1.7) than in the group that did not attempt FP (age 14.2 years ± 1.7; p = .003; figure 5). Tanner stage and testicular volume were also higher in the group who attempted FP (Tanner stage G5, range 4-5; testicular volume 17.2 mL vs. G4, range 2-5; 13.4 mL), but these differences were not significant. The mean IQ in this population was 100 ± 17. The mean IQ in the group who attempted FP was not significantly different from that in the group who did not (respectively 94 ± 15 vs. 103 ± 18; p = .17). Figure 4. Counselling about fertility preservation, attempted fertility preservation, and successful fertility preservation (sperm suitable for IUI or ICSI preserved) among 35 transgirls Fertility preservation Note. ICSI refers to intracytoplasmic sperm injection; IUI refers to intrauterine insemination.
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