Planned Parenthood

Someone asked us:

Hi, I am a trans woman (mtf), and have been on hrt for almost 3 years. I come from a family of very fertile males. My S.O. and I want to become pregnant. How likely is it that we might be able to make this happen? If I were to put my hormone regimen on hold for a while, would that be enough to make it happen? Or are there other things that we can do to make this work for us?

Hormone replacement therapy (HRT) does typically lower sperm count. But taking a break from your hormone treatment may help your sperm count go up again. Typically, it’s recommended to stop hormones for about 3 months. However, there isn’t much research on this topic so we don’t really know how long of a break is enough to get to a sperm count where pregnancy is likely to happen. While there’s no guarantee that your sperm count will return, lots of trans women have been able to cause a pregnancy with their partner after taking a break from hormones. Some people freeze their sperm (cryopreservation) before starting hormones, but this is expensive, and doesn’t guarantee future fertility.

If you’re unsure of your sperm count and mobility after several months of not being on hormones, a semen analysis may answer some of these questions about your fertility. Some Planned Parenthood health centers offer this kind of testing, as well as urologists, reproductive endocrinologists, and other fertility specialists. You may want to consider Assisted Reproductive Technology (ART) if you and your partner are having trouble getting pregnant after stopping hormones for several months, although this is expensive as well.

Real talk: fertility testing and treatment can be really expensive if your insurance doesn’t cover the cost, and finding fertility specialists knowledgeable and respectful of trans identities and health care may also be a challenge, depending on where you live. Your nearest Planned Parenthood health center may have info on good providers in your area. You can also ask the doctor or nurse you visit for HRT about your next steps and trans-friendly fertility specialists near where you live.

In the meantime, it’s a good idea for your partner to have a pre-pregnancy check up.

Best of luck!

-Emily at Planned Parenthood