A study from US Fertility, presented at the 81st ASRM Scientific Congress and among the largest of its kind to date, found that transgender men undergoing IVF experience embryo development and live birth outcomes comparable to cisgender women, including those with a history of testosterone therapy. For transgender men considering fertility treatment, here's what the current outcomes data and clinical protocols actually look like.

A note on this guide: Fertility protocols for transgender patients should always be individualized with a reproductive endocrinologist experienced in transgender care. This article summarizes published outcomes research and general protocol patterns, not a treatment plan for any individual patient.

What the newest outcomes data shows

The US Fertility study analyzed 24 transgender men who underwent 27 IVF cycles, compared against a cohort of 50 cisgender women who underwent 61 IVF cycles. The results were notably favorable:

83%cumulative live birth, transgender male embryos
69%cumulative live birth, cisgender comparison group
63%live birth per transfer, transgender male embryos

Live birth per embryo transfer was 63% for embryos from transgender men, compared with 41% for the cisgender comparison group. Embryo development outcomes were comparable between the two groups overall, and, importantly, among transgender men with prior testosterone exposure, live birth outcomes were similar to those without prior testosterone exposure.

Why this matters clinically

“Our findings demonstrate that transgender men can achieve pregnancy outcomes on par with cisgender women, even in patients with prior testosterone exposure,” said Kyle N. Le, M.D., the study's lead author and a Reproductive Endocrinology and Infertility fellow at Shady Grove Fertility. Prior research in this space had focused mostly on egg retrieval outcomes; this study is among the first and largest to look specifically at embryo development and transfer outcomes as well.

This builds on earlier, smaller research, including a Boston IVF study that found trans men who began testosterone therapy before fertility preservation had egg yields comparable to cisgender patients, and additional case-series data showing that even long periods of gender-affirming hormone therapy didn't appear to negatively affect ovarian stimulation outcomes.

What a typical protocol involves

Every plan is individualized, but a general pattern has emerged across the published literature and clinical guidance for transgender men pursuing IVF using their own eggs:

  1. Pausing testosterone therapy. Most protocols involve discontinuing exogenous testosterone for a period before ovarian stimulation begins, commonly a few months, to allow menstrual cycling to resume. The exact duration is individualized based on how long someone has been on testosterone and how quickly their cycle returns.
  2. Ovarian stimulation. Standard gonadotropin stimulation protocols, similar to those used for cisgender patients, are typically used, with monitoring via bloodwork and ultrasound.
  3. Egg retrieval. A standard retrieval procedure, performed under sedation, generally taking 15–30 minutes.
  4. Fertilization and embryo creation. Using partner or donor sperm, following the same lab processes used in any IVF cycle.
  5. Transfer. Embryos may be transferred to the transgender man himself (if he retains a uterus and chooses to carry), to a partner, or to a gestational carrier, depending on the individual or couple's plans.
  6. Resuming testosterone. Most patients resume gender-affirming hormone therapy after egg retrieval or after pregnancy, in coordination with both their fertility team and their primary gender-affirming care provider.

The emotional and clinical experience

Pausing testosterone, even temporarily, can be a significant experience for transgender men, sometimes involving the return of menstruation and shifts in mood or physical presentation. Clinics experienced in transgender fertility care generally build in mental health support and clear communication about what to expect, and coordinate closely with a patient's existing gender-affirming care team throughout the process.

Finding an experienced clinic

Not every fertility clinic has deep experience with transgender patients specifically. When researching clinics, it's reasonable to ask directly: how many transgender patients has this clinic treated, does the clinic use gender-affirming language and intake forms, and how does the clinic coordinate with a patient's endocrinologist managing their hormone therapy.

Frequently asked questions

Do I have to stop testosterone completely to do IVF?

In most protocols, yes, temporarily. The exact timeline is individualized, but pausing exogenous testosterone is typically necessary to allow the ovaries to resume normal cycling in preparation for stimulation. This is a conversation to have directly with your RE about your specific timeline and goals.

Does prior long-term testosterone use hurt my chances?

The current data is reassuring on this point. The 2026 US Fertility study specifically found that live birth outcomes among transgender men with prior testosterone exposure were similar to those without, and earlier research found long periods of hormone therapy didn't appear to negatively affect ovarian stimulation outcomes.

Can I carry the pregnancy myself?

Some transgender men choose to carry, others transfer to a partner or use a gestational carrier. This is a deeply personal decision that your fertility team should discuss with you as part of building your overall treatment plan, alongside your broader gender-affirming care goals.