Can Transgender Men Do IVF After Testosterone Therapy? Key Findings From 2026 Study

For transgender men (transmasculine people assigned female at birth, AFAB), testosterone therapy is often an essential part of gender affirmation. If biological children are part of your family-building goals, a common practical question arises: can you still pursue IVF after starting testosterone?

A March 2026 retrospective cohort study from the Oregon Health & Science University (OHSU) research team, published in Human Reproduction, sheds light on this question.

What Did the Study Find?

Researchers analysed 36 transgender-male (25 undergoing IVF, 11 pursuing egg freezing), comparing outcomes between people with prior testosterone exposure and those without prior testosterone therapy.

Below are the key take-aways.

Egg retrieval is still feasible

After adjusting for age, there was no statistically significant difference in the number of mature eggs retrieved between the two groups. Testosterone therapy does not fully shut down ovarian response, so egg retrieval is still clinically possible.

Higher attrition: more egg loss on the path to blastocysts

Participants with prior testosterone therapy produced fewer usable blastocysts overall, along with fewer high-quality blastocysts. Even when adequate numbers of eggs are retrieved, a higher share may fail to develop to the blastocyst stage.

Shorter testosterone washout linked to fewer high-quality blastocysts

Patients who stopped testosterone less than six months before starting IVF had significantly fewer top-quality blastocysts (P=0.01). This suggests sufficient washout time may benefit embryo quality, an important topic to discuss with your clinician when you plan IVF.

Note: This finding comes from a posthoc subgroup analysis and was not the study’s primary endpoint. It needs further validation in larger patient groups.

Live-birth rates: 60 % versus 87.5 %

Cumulative live-birth rates for the first complete IVF cycle were 60 % in the prior-testosterone group and 87.5% in the no-testosterone group.

Although there is a gap of more than 27 percentage points, this difference was not statistically significant, which does not mean that testosterone treatment has actually reduced the live birth rate.  

Critical caveat: The study’s sample size is small (total 36 participants). Observations should be interpreted cautiously and require confirmation in larger cohorts. Individual outcomes vary widely based on testosterone-use duration, dosage, and personal ovarian biology.

What Do These Findings Mean for Transgender Men?

1. If you have used testosterone therapy, IVF is still a viable family-building option. Study data confirms ovaries can still respond to ovarian stimulation, and egg retrieval is achievable.

2. Discuss washout timing with your provider. Shorter testosterone washout periods correlated with fewer high-quality blastocysts in this subgroup observation. Timing of pausing testosterone should be reviewed early in your treatment planning.

3. Individualised assessment is non-negotiable. Length of testosterone use, dosage, and baseline ovarian function all shape expected outcomes. Work with a reproductive-health specialist to build a customised care plan.

The Bottom Line

For transgender men who have taken testosterone, pursuing IVF for biological children remains realistic. This 2026 study shows cumulative live-birth rates of up to 60 % in this population. While lower than the nontestosterone group’s rate, this still represents a meaningful chance of success.

The best first step is an early consultation with a knowledgeable reproductive-medicine specialist to review your personal ovarian status and map out your treatment pathway.

Have questions around fertility preservation and IVF for transgender and gender-diverse patients? Connect with the CEF fertility team. Email info@cefivf.com or visit our Contact page.

Disclaimer: This article summarises findings from a 2026 retrospective cohort study published in Human Reproduction. It does not constitute personalised medical advice. Always consult a culturally-competent licensed reproductive-endocrinology provider for your individual care decisions.