As a non-binary person, you may have questions about what family-building options are available to you. Main Line Fertility is specifically trained in the principles of transgender and non-binary inclusion, and we are ready to support your journey!

We know that all transgender people, and especially non-binary community members, transition (or not!) at their own pace. We also recognize that non-binary people may use gender-neutral pronouns (or not!) and commit to providing you with opportunities to share your personal pronoun with us. We also commit to remembering and correctly using your pronoun every time. If a mistake about your chosen name or personal pronoun is made, we are committed to fixing the mistake as soon as we realize it is made, to appreciating you if you are able to correct us, and to being in humble, responsive relationship with you. We have also undergone a process to remove all gendered language from our website and forms wherever possible (understanding that some of our legally-required documentation is supplied by federal and/or state organizations which may not share our commitment to inclusion).

Wherever you fall under the non-binary umbrella, there are many ways to consider forming your family. We’ll outline a few of your options here! If you have questions about any of these items, or have a question that isn’t covered here, feel free to reach out to us directly.

No Hormonal or Pre-Hormonal Transition: Sperm

If your body produces sperm and you plan to transition hormonally or surgically, it is considered best practice to capitalize on your existing fertility before transitioning medically. If you’re not ready to become a parent yet, a great option is to engage in fertility preservation while your body is still producing sperm. It is not currently known exactly how hormones will impact your long-term fertility prospects; the best data suggests that roughly 50% of all transgender women lose some or all of their fertility capability within just a few months of starting Hormone Replacement Therapy. While some are able to regain their fertility later on, the chances of that happening are unknown and the process requires you to stop your HRT, which many trans community members would prefer not to do.

If you ARE ready to become a parent now, there are several things you can do to increase the chances of contributing to a successful pregnancy quickly. Many transgender women share that they don’t want to postpone their transition longer than necessary, so it can be helpful to take steps to expedite the pregnancy process if possible. One thing to note is that there is some evidence that transgender women may have lower fertility levels (including lower volume, sperm count, mobility, motility, and morphology) even before transitioning medically. So there’s a chance that you might need a bit of medical assistance to contribute to a pregnancy.

What can you do?

Sign up for a fertility work-up, which only requires one in-office visit and is usually covered in full by insurance. This will give you a crystal-clear look at YOUR fertility capability right now, so you don’t have to postpone your transition any longer than necessary.

No Hormonal or Pre Hormonal Transition: Eggs

If your body has eggs and you plan to transition hormonally or surgically, you have a few options available to you. You may choose to go through an egg harvesting process, which is especially important if your age is a concern to you. You can freeze your eggs now and use them at a later date, either for your own pregnancy or a pregnancy that may be carried by a partner or surrogate.

Hormones and Fertility

Estrogen-based hormones and androgen blockers have a negative effect on every aspect of fertility for transgender women. In some cases, the effects are reversible and enough fertility can be regained if HRT is stopped for a period of time. Our providers are able to support you through this process, doing regular semen analyses to reduce the amount of time you have to be off of HRT. In some cases, additional prescription medications can assist with sperm production; our providers can walk you through the options that are most likely to lead to increased fertility levels for your unique case.

Testosterone, however, is believed to have temporary (reversible) impacts on fertility. Specifically, testosterone does impact ovulation (the process through which your body matures eggs and gets them ready for fertilization) while you’re taking it. But many studies show that ovulation usually returns after only a few months spent off of testosterone. Our providers can work with you to manage the effects of stopping your testosterone regimen, tracking your fertility closely to minimize your time off of hormones.