The Challenge of Fertility Preservation for Transgender Women
At Maze Labs, we recognize that fertility preservation can be especially complex for transgender women, particularly those who have been on long-term gender-affirming hormone therapy. Traditional methods like sperm banking or testicular extraction often fail after extended hormone use—especially when stopping therapy isn’t an option due to emotional or medical concerns.
What Is ESSM (Extended Sperm Search and Microfreeze)?
To address this gap, Maze Labs has pioneered a new technique in the U.S. called Extended Sperm Search and Microfreeze (ESSM). This advanced approach is designed for patients with azoospermia—a condition where no sperm are found in a standard semen analysis.
Using high-powered microscopy, ESSM meticulously scans semen or testicular samples for even the smallest presence of sperm. If any are found, they are carefully isolated onto a specialized device called a SpermVD, allowing for microfreezing and future use in IVF
Learn more about ESSM at Maze Labs
Case Series: Sperm Retrieval Success After Hormone Therapy
In collaboration with New York University, we recently presented a case series featuring three transgender women who had been on hormone therapy for between 6 and 21 years. Each showed complete azoospermia on standard semen analysis.
With ESSM, however, two of the three patients were able to retrieve and preserve viable sperm. Remarkably, one patient showed no sperm even after a microTESE (microsurgical testicular sperm extraction), but ESSM was still able to find and freeze viable sperm—highlighting the potential of this technique to succeed when other methods fail.
A Game-Changing Fertility Option for the Trans Community
ESSM represents a meaningful new pathway for fertility preservation, especially for transgender women who began hormone therapy before banking sperm. It provides hope, options, and the ability to make empowered reproductive decisions—even years into medical transition.
At Maze Labs, we are proud to lead the way in supporting transgender fertility and advancing inclusive reproductive medicine.
Ready to Learn More?
If you or someone you care about is exploring fertility options as a transgender woman, we invite you to reach out. Our compassionate and expert team is here to answer questions and help you navigate the best possible path forward.
Contact us today to schedule a consultation.
