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41 IMPAIRED SEMEN QUALITY IN TRANS WOMEN 3 were dichotomized using WHO reference values to be able to compare impaired semen quality with normal semen quality. 10 Odds ratios (OR) with 95% CI were calculated. STATA Statistical Software, version 15.1 (Statacorp, College Station, TX, USA) was used for statistical analyses. RESULTS Description of study population Our cohort consisted of 260 trans women who provided at least one semen sample for cryopreservation between August 1991 and December 2017. The median age at time of semen cryopreservation was 24.0 years (IQR 20.0-29.5). Alcohol consumption, smoking status, cannabis use and BMI were comparable to the general Dutch population and no abnormalities were found in the endocrine laboratory results (Table 1). 74 The medical history of 13 trans women was positive for inguinal hernia repair or cryptorchidism.Anxiety or depression was reported in 34 trans women. In total, 12 trans women reported to have used anti-androgens and estrogens, and all had discontinued for at least 3 months prior to the first attempt for semen cryopreservation. The median number of semen samples provided per person was 3.0 (IQR 2.5-3.0), and in total 748 semen samples were included for analyses.