Préservation de la fertilité chez les hommes trans : freins et motivations
Bibliographic record
Abstract
Objectifs: Face à la faible proportion d’hommes trans (personnes trans assignées femmes à la naissance - FtX) ayant recours à la préservation ovocytaire malgré une information systématique, cette étude visait à identifier leurs motivations et freins dans le cadre d’un parcours de transition au CHU de Lille. Méthodes: TRANSPF est une étude observationnelle, transversale, monocentrique, incluant les personnes majeures FtX reçues en consultation entre mai 2018 et mai 2024. Un questionnaire, validé par un comité d’éthique, a permis de recueillir des données démographiques, sur le parcours de soins, les connaissances, motivations, et freins. L’analyse statistique a été réalisée avec JAMOVI. Résultats: Parmi les 362 personnes FtX reçues, seules 31 (8,5 %) ont réalisé une cryopréservation ovocytaire, un taux inférieur à la moyenne nationale. Sur 221 personnes contactées, 67 questionnaires complets ont été analysés (taux de réponse : 30 %, âge moyen : 23 ans). Si 82 % connaissaient la possibilité de préserver leur fertilité, les connaissances techniques restaient partielles. La motivation principale était le recours à la méthode ROPA - Réception des Ovocytes de la/du Partenaire (45 %). Les freins évoqués comprenaient l’interruption de l’androgénothérapie (45 %), la voie endovaginale (46 %), la lourdeur du protocole (37 %) et la crainte d’un mauvais accueil médical (31 %). Conclusions: Une information claire et inclusive sur la préservation de la fertilité est essentielle. Les freins psychologiques, techniques et législatifs doivent être mieux pris en compte, en lien avec la formation des soignants et une réflexion bioéthique sur la parentalité trans. Objectives: Given the low proportion of trans men (individuals assigned female at birth – FtX) opting for oocyte preservation despite systematic information, this study aimed to identify their motivations and barriers within a gender transition pathway at Lille University Hospital. Methods: TRANSPF is an observational, cross-sectional, single-center study including adult FtX individuals seen for fertility preservation consultation between May 2018 and May 2024. An online questionnaire, approved by an ethics committee, collected demographic data, information on care pathways, knowledge, motivations, and barriers. Statistical analysis was mainly descriptive, performed using JAMOVI. Results: Among the 362 FtX individuals seen, only 31 (8.5%) underwent oocyte cryopreservation—a rate below the national average. Of the 221 people contacted, 67 complete questionnaires were analyzed (response rate: 30%, mean age: 23). While 82% were aware of the possibility of preserving fertility, technical knowledge remained limited. The main motivation for preservation was the potential use of the ROPA method (Reception of Oocytes from the Partner) (45%). Reported barriers included the need to interrupt androgen therapy (45%), the transvaginal retrieval method (46%), the burdensome nature of the protocol (37%), and fear of poor medical reception (31%). Conclusions: Clear, inclusive, and up-to-date information on fertility preservation is essential. Psychological, technical, and legal barriers must be more thoroughly addressed within care pathways. Greater healthcare provider training and broader bioethical reflection—particularly regarding trans parenthood and post-transition use of gametes—are necessary to improve access to fertility options for trans individuals.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".