In early October 2025, a special visitor arrived in the consultation room of Tulip International Reproductive Center. Her name is Nana (pseudonym) and she came all the way from Beijing. She has a tall figure, wearing an elegant long dress, with delicate makeup, and exudes a calm feminine charm in every movement and gesture.
Hello, I have made an appointment for fertility preservation consultation. "Her voice was gentle and clear.
In deep communication with experts, Nana candidly shared her story: she is a transgender woman who has undergone years of hormone replacement therapy (HRT) and her body is gradually aligning with her inner identity. However, in her heart, there is always an unextinguished dream - in the future, to have a child with her loved one who flows with her own blood.
I know my situation is a bit special, "her eyes were mixed with anticipation and anxiety." Due to various reasons, I didn't have time to freeze my sperm before starting HRT. Can I still become a biological mother now? ”
Her question touches upon a profound issue that is often overlooked by society but concerns fundamental human rights: the reproductive rights of transgender individuals also need to be seen, respected, and protected.
Crossroads of Identity: When 'Becoming Yourself' Meets' Becoming a Mother '
For many transgender women, the issue of childbirth is an extremely complex and painful crossroads on the path to embracing their true selves. Hormone replacement therapy (HRT) - using exogenous estrogen and anti androgen drugs - is the core medical method for achieving feminization of the body. However, a clear and significant side effect of this treatment is that it can cause serious and even irreversible damage to fertility.
How does HRT affect fertility?
Inhibiting the hypothalamic pituitary gonadal axis: Exogenous estrogen sends a "false signal" to the brain, causing it to believe that the body no longer needs to produce testosterone. The pituitary gland, the command center of the brain, will stop secreting gonadotropins (LH and FSH), which is equivalent to cutting off the signal chain that sends "production instructions" to the testes.
The process of spermatogenesis stagnates: Without the "command", the seminiferous tubules in the testes will stop working. The number of sperm produced will sharply decrease, usually reaching a state of azoospermia or severe oligozoospermia within a few months.
This brings about a huge contradiction: in order to become their true and complete selves, they may have to give up the possibility of becoming biological parents. Nana chose to preserve her fertility not to play the traditional role of a "father", but to contribute her genetic makeup to her future family as a mother. Behind this lies her self definition as a complete woman, as well as her love and responsibility for the future family.
Make way for hope in life: Stop HRT, restart vitality
For transgender women like Nana who have already started HRT and want to obtain healthy sperm, the most mainstream and evidence-based solution currently is to temporarily stop under the guidance of a doctor.
Why must it stop?
Only by stopping the intake of exogenous estrogen and anti male drugs, can the body's endocrine axis be freed from inhibition, and the brain may resume secreting gonadotropins, thereby "awakening" the dormant testes and attempting to restore sperm production.
How long does it need to stop?
This is a highly individualized question with no standard answer. Usually, reproductive experts recommend stopping for at least 3 to 6 months. During this period, it is necessary to closely monitor the recovery situation through regular blood hormone level testing and semen analysis. This process may be accompanied by a brief return of some masculine signs, which can be a challenging physical and mental test for transgender women.
What are the chances of recovery?
Recovery is not a 100% guarantee. The longer the duration of HRT and the older the age at which treatment begins, the more difficult it is to fully restore spermatogenic function.
Real Case: Nana's Decision and Perseverance
After in-depth communication with the expert team of Tulip International Reproductive Center, Nana made a brave decision. With the joint support of endocrinologists and psychological counselors, she gradually reduced and eventually stopped HRT.
Process: In the first month, her emotions fluctuated greatly and her skin began to oil up. But the biweekly follow-up and psychological support gave her tremendous strength. In the third month after discontinuing the medication, her semen analysis report showed that a small amount of active sperm had finally appeared! Although the quantity and vitality are far from ideal, this is already a huge breakthrough.
Result: In the fifth month after discontinuing the medication, her sperm count and vitality reached the standard for cryopreservation. On that day, she successfully collected several precious semen samples in our sperm collection room.
The 'time capsule' of life: sperm freezing technology
Nana's semen sample was immediately sent to the top embryology laboratory of the Yujin Xiang International Fertility Center, entering the "time capsule" of life.
Processing and freezing: Embryologists add special cryoprotectants to semen to protect sperm cells from ice crystal damage during the cooling process. Subsequently, these samples were divided into cryovials labeled with her unique identification and carefully placed in liquid nitrogen tanks at -196 ℃. At this extremely low temperature, all biological activities have come to a halt, and time seems to freeze.
Long term preservation and future use: In theory, frozen sperm can be preserved indefinitely. When Nana decides to use them in the future, these sperm will be revived for subsequent assisted reproductive processes.
The Road to Motherhood: Future Fertility Plans
The successful freezing of sperm was the first step on Nana's path to becoming a mother. In the future, she can achieve her dreams through the following ways:
Forming a family: She may form a family with a cisgender woman in the future.
Collaborative IVF: At the appropriate time, her frozen sperm will be revived and combined with her partner's egg in the laboratory through in vitro fertilization (IVF) technology to form an embryo.
Pregnancy: Ultimately, a healthy embryo will be transplanted into her partner's uterus, completing implantation, development, and delivery.
In this process, genetically, the child will inherit her genes; From a legal and social perspective, she will be the rightful mother of the child.
Everyone's right to reproduction deserves respect
Nana's story is a microcosm of millions of transgender people pursuing a complete life. The right to reproduction is a fundamental human right and should not be deprived based on gender identity. At Tulip International Reproductive Center, we are committed to providing the most professional, friendly, and humane medical services for all diverse families, including transgender individuals.
We believe that the light of science will eventually illuminate every path towards love and family.
For fertility consultation in Kyrgyzstan, please contact your dedicated consultant
/Fertility Consultation /
Dr.Chan
Copy and add: Tulip_EnoChan
Or long press/scan the QR code to add
Tulip International Fertility Center
Technology aids fertility, fulfilling dreams for countless families
