Egg Freezing Before or During Gender-Affirming Care: Your Questions Answered
For anyone who is transitioning or planning gender-affirming care, fertility preservation can be an important conversation to have early on.
Egg freezing is not the right choice for everyone, nor does it mean you have to have your entire future mapped out right now. For many, it is simply a way to keep doors open, giving you the option to have a genetic connection to future children if and when that time feels right.
At EVOLVE, our role is to provide clear, affirming, and evidence-based information so you can make informed decisions on your own timeline. Below, our fertility specialists address common questions about egg freezing, Ontario funding, testosterone, and what to expect.
Why consider egg freezing before gender-affirming care?
Certain gender-affirming treatments, including hormone replacement therapy and gender-affirming surgeries, can affect future fertility. For individuals who may want the option to use their own eggs later in life, freezing eggs before undergoing these treatments preserves them at their current biological age.
Frozen eggs can be stored indefinitely and used years down the road through in vitro fertilization (IVF). Taking the time to understand your fertility status does not mean putting your transition on hold. It simply ensures you are fully informed about your options before moving forward.
Would I be eligible for an Ontario-funded egg freezing cycle?
Under the Ontario Fertility Program (OFP), egg freezing can be funded by OHIP when it is considered medically necessary to preserve fertility prior to medical treatments or therapies that could impact future reproductive health.
Because provincial coverage requires clinical documentation, eligibility is reviewed and established directly by an EVOLVE reproductive physician during your consultation. Our clinical team has extensive experience working with patients undergoing gender-affirming transitions, navigating provincial funding criteria, and documenting medical necessity on a case-by-case basis.
If you are planning or actively undergoing gender-affirming medical care, an initial consultation with an EVOLVE physician is the first step to determining your eligibility.
Will one egg freezing cycle be enough?
Under the Ontario Fertility Program, provincial funding covers one funded egg freezing cycle per person in a lifetime.
Whether a single cycle retrieves enough mature eggs to provide strong future options depends on several individual factors, including your age, your current ovarian reserve, and how your ovaries respond to stimulation medication.
During your consultation, your EVOLVE doctor will review your baseline fertility testing and outline realistic expectations for your cycle, discussing whether one cycle meets your personal family-building goals.
Will Ontario funding cover all of my expenses?
If you are approved for a funded cycle under the Ontario Fertility Program, the provincial funding covers the clinical monitoring (bloodwork and ultrasounds during your cycle) and the egg retrieval procedure itself. Most of your initial diagnostic testing at our clinic is also covered by OHIP, with the exception of the Anti-Müllerian Hormone (AMH) test.
Certain expenses are not covered by provincial funding:
- Medications: The fertility hormones required to stimulate the ovaries are not covered by OHIP. However, many private and employee health benefit plans offer partial or full coverage for these prescriptions.
- Storage fees: Ongoing annual storage fees for frozen eggs are billed out-of-pocket, though your first year of storage may be included depending on clinic packages.
Our clinical team and patient navigators will walk you through a transparent financial breakdown before you begin so there are no surprises.
Do I need to discontinue testosterone before proceeding with egg freezing?
If you have already started testosterone, you do not need to abruptly stop before meeting with us. You can remain on your current hormone regimen while completing your baseline testing and having your initial consultation with an EVOLVE physician.
At your consultation, your doctor will discuss whether a temporary pause in testosterone is recommended for cycle stimulation and help map out a timeline that prioritizes both your emotional well-being and clinical outcomes.
Should I wait to start testosterone until after freezing my eggs?
If you have not yet started testosterone and feel comfortable waiting a brief period, completing your egg freezing cycle beforehand can simplify the process. It allows our clinical team to assess your ovaries in their baseline state and begin a cycle without requiring you to start and then pause hormone therapy.
However, your gender-affirming care and timeline are entirely personal. If you are eager to begin testosterone, speaking with an EVOLVE nurse or physician right away can help you coordinate both care paths smoothly.
What happens during an egg freezing consultation?
An initial consultation is simply a conversation to explore your options with zero pressure or commitment. During this visit, your EVOLVE physician will:
- Review your baseline ultrasound and hormone bloodwork.
- Discuss your transition goals, hormone history, and timeline.
- Assess your eligibility for Ontario Fertility Program funding.
- Walk through the practical day-to-day routine of a cycle, including medications, morning monitoring visits, and retrieval.
- Answer any questions you have about egg storage or future family-building.
Talk to an EVOLVE Nurse
Navigating fertility preservation alongside gender-affirming care comes with unique questions, and you do not have to figure it out alone.
Whether you want to learn more about Ontario funding eligibility, understand how testing works, or discuss cycle timing, our nursing team is here to support you with compassionate, non-judgmental care.
You can book a complimentary, 30-minute phone call with an EVOLVE nurse to get answers and take the first step:
