Iris de Nie

61 A COHORT STUDY ON FACTORS IMPAIRING SEMEN QUALITY IN TRANSGENDER WOMEN 4 Table 5. The effect of ejaculation frequency, wearing tight undergarment, and tucking on semen volume, sperm concentration, total sperm number and progressive motility Semen volume < 1.5 ml OR (95% CI) Sperm concentration < 15x10 6 OR (95% CI) Total sperm number < 39x10 6 OR (95% CI) Progressive motility < 32% OR(95% CI) Ejaculation frequency (per month) Univariable analysis Average (6-12x) vs low ( < 6x) High ( > 12x) vs low ( < 6x) Multivariable analysis^ Average (6-12x) vs low ( < 6x) High ( > 12x) vs low ( < 6x) 0.38 (0.13-1.11) 0.46 (0.16-1.30) 0.35 (0.11-1.10) 0.36 (0.11-1.21) 0.94 (0.35-2.51) 0.67 (0.24-1.83) 1.11 (0.38-3.22) 0.64 (0.19-2.07) 0.89 (0.34-2.29) 0.53 (0.19-1.42) 1.05 (0.37-3.01) 0.56 (0.17-1.81) 4.33 (1.11-16.89)* 3.01 (0.75-12.06) 4.78 (1.11-20.48)* 2.24 (0.48-10.55) Wearing tight undergarment Univariable analysis Sometimes vs never Always vs never Multivariable analysis^ Sometimes vs never Always vs never 1.29 (0.42-4.01) 0.80 (0.30-2.14) 1.06 (0.32-3.53) 0.71 (0.24-2.03) 0.93 (0.29-3.01) 2.24 (0.93-5.42) 0.92 (0.27-3.17) 2.71 (1.01-7.24)* 1.71 (0.59-5.00) 1.68 (0.70-4.02) 1.66 (0.51-5.37) 2.01 (0.76-5.34) 1.08 (0.26-4.55) 4.38 (1.61-11.88) 1.15 (0.26-5.10) 3.63 (1.27-10.37)* Tucking Univariable analysis Sometimes ( < 8x) vs never Often ( > 8) vs never Multivariable analysis^ Sometimes ( < 8x) vs never Often ( > 8) vs never 0.37 (0.08-1.75) 1.11 (0.26-4.64) 0.44 (0.08-2.24) 1.21 (0.25-6.02) 0.78 (0.23-2.65) 3.52 (0.92-13.52) 1.05 (0.28-3.90) 5.48 (1.18-25.59)* 0.24 (0.05-1.13) 2.53 (0.66-9.65) 0.30 (0.06-1.55) 3.39 (0.75-15.36) 0.51 (0.12-2.45) 3.58 (0.94-13.67) 0.49 (0.10-2.47) 2.76 (0.65-11.68) ^Correction for demographic factors (age, BMI) + lifestyle factors (alcohol consumption, smoking, cannabis use) + medical history (previous hormone use, urological problems, anxiety and depression) *p-value < 0.05 using logistic regression analysis COMMENT Principal findings This current study showed once more that semen quality in transgender women is decreased compared to the general population, even prior to GAHT. A negative impact of always wearing tight undergarment and extensive tucking on TMSC was observed. The association with tucking was independent of demographic factors, lifestyle factors and medical history. Results in the context of what is known The median semen parameters observed in the current study are in line with previous studies and similar to the results of the large retrospective cohort study we performed in 2019. 34,35,96 Post-thaw semen quality was in only 23.3% of samples adequate for IUI. When comparing baseline characteristics of the current cohort with the retrospective cohort, data on demographics and lifestyle appear to be very similar and show a young, relatively healthy population. However, the prospectively obtained data on medical history show a high percentage of people with anxiety or depression, and previous urological