Fertility is something to consider for all trans people who wish to undergo some form medical transitioning, whether it is hormonal or surgical. ### Transwomen #### Sperm freezing: Fastest and most viable option, although costs, inconvenience due to laws, and other factors can complicate things. The law around sperm freezing in Hong Kong only allows for a period up to 10 years, and fertility treatments using said sperm can only be given to legally married spouses, meaning that *IF* you've changed your gender markers to Female on your HKID card, your female spouse will essentially be unable to use your sperm for fertility treatment until gay marriage is legal in Hong Kong, nor will you be able to provide it to a surrogate. Given the above, this means you will have to either refrain from changing gender markers or fly to a different country where the laws are different, incurring extra costs and also be burdened by the laws of that region. #### Hormone cycling: [Clomiphene](https://en.wikipedia.org/wiki/Clomiphene) is a medication typically given to natal females to improve their fertility, but has also been shown to be effective in assigned male at birth people in raising their sperm count and quality by stimulating the production of [Follicle Stimulating Hormone](https://en.wikipedia.org/wiki/Follicle_stimulating_hormone) and [Luteinizing Hormone](https://en.wikipedia.org/wiki/Luteinizing_Hormone). Of particular interest is the isomer [Enclomiphene](https://en.wikipedia.org/wiki/Enclomifene) which has been shown to be more effective. For more information on how these hormones interact please read [[Effects of Hormone Therapy]]. *Please note that the general maturation time for sperm is around 90 days.* Hormone cycling shorter than 90 days is unlikely to restore fertility to the point where non-assisted pregnancy is statistically viable (nevertheless the risk of getting pregnant is never zero). It however, is likely to reduce the damaging effects of Estrogen on Leydig cells as discussed in [[Effects of Hormone Therapy]]. Medication types: 1. Clomiphene (Typically sold under the name Clomid): 'Multi isomer form of Clomiphene, which is more readily available. It is around 30-50% less effective than the purified isomer form Enclomiphene. Typical dosages for Clomid start at around 25mg/daily up to 100mg/daily. 2. Enclomiphene: Pure isomer form of Clomid, less estrogenic effects makes it more potent. ### Transmen #### Hormone cycling Taking testosterone generally stops the menstrual cycle, however this process is generally reversible and there are many well documented cases of transmen getting pregnant and even lactate. *(as long as top surgery has not been performed)* After stopping Testosterone, and possibly with the assistance of other medication such as Clomid, ovulation can resume within a few months. #### Egg freezing Egg freezing is a viable path to maintain fertility. It has several advantages over hormone cycling, in that the eggs are frozen at a younger age, and can theoretically extend fertility beyond menopause. However, the costs are high, and the medication used to induce ovulation can be taxing on the body. The success rate for in-vitro fertilization also decreases with age and surrogacy is a difficult process from legal, logistical, and cost perspectives.