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BioMed Research International
Volume 2018, Article ID 7919481, 5 pages
Research Article

Spermatogenesis Abnormalities following Hormonal Therapy in Transwomen

1Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
2Division of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
3Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
4Preecha Aesthetic Institute, Bangkok, Thailand

Correspondence should be addressed to Sirachai Jindarak; moc.liamg@iahcaris.rd

Received 24 October 2017; Revised 3 January 2018; Accepted 1 March 2018; Published 2 April 2018

Academic Editor: Takashi Yazawa

Copyright © 2018 Sirachai Jindarak et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To measure spermatogenesis abnormalities in transwomen at the time of sex reassignment surgery (SRS) and to analyze the association between hormonal therapy duration and infertility severity. Design. Retrospective study. Setting. University hospital. Patients. One-hundred seventy-three transwomen who underwent SRS from January 2000 to December 2015. Interventions. All orchidectomy specimens were retrospectively reviewed and classified. History of hormonal therapy duration was retrieved from medical records. Main Outcome Measures. Histological examinations of orchidectomy specimens were performed to assess spermatogenesis. Results. One-hundred seventy-three orchidectomy specimens were evaluated. Histological examinations showed maturation arrest in 36.4%, hypospermatogenesis in 26%, Sertoli cell-only syndrome in 20.2%, normal spermatogenesis in 11%, and seminiferous tubule hyalinization in 6.4% of the specimens. Spermatogenesis abnormality severity was not associated with the total therapy duration () or patient age at the time of surgery (). Testicular volumes and sizes were associated with spermatogenesis abnormality severity ( and , right testicle and left testicle, resp.). Conclusion(s). Feminizing hormonal treatment leads to reductions in testicular germ cell levels. All transwomen should be warned about this consequence, and gamete preservation should be offered before starting hormonal treatment.