Iris de Nie

94 C H A P T E R 6 Hyalinization of seminiferous tubules was observed in 161 orchiectomy specimens (75.2%) and was most common in the adult subgroup (Figure 3E and F). An open or half-open lumen of the seminiferous tubule was encountered in 8.4% and 25.2% of the orchiectomy specimens (Figure 3A and B), respectively. The complete absence of a lumen was most common in those who initiated treatment in Tanner stage 2 or 3 (Figure 3C). Figure 3. Different aspects of lumen and degrees of hyalinization of seminiferous tubules. A. Open lumen, B. Half-open lumen, C. Absent lumen, D. No hyalinization, E. Mild hyalinization, F. Severe hyalinization. Bar represents 20µm. When comparing the options for fertility preservation, we found that for some transgender women it would still have been possible to harvest mature spermatozoa from testicular tissue obtained during gGAS (Figure 4). This was the case for 4% (95%CI 2-8) of the adult subgroup and 10% (95%CI 4-22) of adolescents in the Tanner stage 4-5 subgroup, compared to 0% in the Tanner stage 2-3 subgroup. For 100% of people in the Tanner stage 2-3 subgroup, 90% (95%CI 78-96) of people in the Tanner stage 4-5 subgroup and 85% (95%CI 78-90) of the adult subgroup, preservation of testicular tissue containing spermatogonial stem cells would have been their only option for fertility preservation. Furthermore, for 11% (95%CI 7-17) of the adult subgroup no options for fertility preservation would have been available, compared to 0% of the two adolescent subgroups. No statistically significant differences were found between those who had continued GAHT until gGAS and those with four weeks cessation of GAHT prior to gGAS. Lastly, logistic regression analyses showed no association between the duration of GAHT and the possibility for preservation of spermatozoa (OR 0.75, 95%CI 0.47-1.18) or spermatogonial stem cells (OR 1.03, 95%CI 0.81-1.31).