147 Use of fertility preservation among a cohort of transgirls in the Netherlands 8 Figure 5. Age at the start of treatment with gonadotropin-releasing hormone analogues in transgirls who did and did not attempt fertility preservation. Mean age was signif icantly lower in the group who did not attempt (n = 23) than in the group who did attempt fertility preservation (n = 12, p = .003) Because options to have children may depend on the sex of future partners, we investigated if sexual orientation was related to the use of FP. Transgirls who did not attempt FP were as likely to be attracted to men only (12 of 19) as transgirls who did attempt FP (10 of 11; p = .2) , but only two transgirls were not attracted to men at all. No significant differences were seen in family situation (living together with both parents vs. separated parents/foster parents/adopted or other) between the two groups. However, fewer Caucasian girls attempted FP than girls with other ethnicities including Asian, African, and South American (20% vs. 70%; p = .02). Forty-seven percent of the transgirls suffered from psychiatric comorbidity (depression, anxiety disorder, posttraumatic stress disorder, or autism spectrum disorder). Those with psychiatric comorbidity were as likely to attempt FP as those without. Information about the desire to have children was present in medical files of 43% of the transgirls. All four transgirls who stated not wanting to have children declined FP, whereas 36% of those who were (potentially) interested in having children attempted FP. Of the 12 adolescents who attempted FP, one was unable to ejaculate. She was 12 years old and at Tanner stage G4, with testicular volume 15 mL. One post-pubertal adolescent had azoospermia, whereas another had severe oligozoospermia with a few viable spermatozoa after thawing in only one sample, considered marginally usable for intracytoplasmic sperm Figure 5. Age at the start of treatment with gonadotropin-releasing hormone analogues in transgirls who did and did not attempt fertility preservation. Mean age was significantly lower in the group who did not attempt (n = 23) than in the group who did attempt fertility preservation (n = 12, p = .003) Attempted fertility preservation
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