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43 IMPAIRED SEMEN QUALITY IN TRANS WOMEN 3 Evaluation of semen variables and their determinants The median values of all semen parameters in our cohort (volume 2.7 ml (IQR 1.9-3.6), sperm concentration 40 million/ml (IQR 13-58.7), total sperm number 103 million (IQR 26.9-182.2) and progressive motility 41% (IQR 26.7-53)) were significantly lower than the WHO data on semen quality in the general population of unscreened men (Figure 1). 10 Figure 1. Box and whisker plots of semen analysis data. The data are semen volume, sperm concentration, total sperm number and percentage progressive motility from trans women compared with World Health Organization (WHO) values for unscreened men from the general population. The boxes represent the quartiles and the lines within them are the medians; the whiskers extend from the 10th to the 90th centiles. * p-value < 0.05 using Wilcoxon signed-rank tests, for panel B,C,and D azoospermic trans women were excluded from analysis.