Pregnancy and Family-Building Options for Transgender Women

Medically Reviewed by Dr. Silvana Chedid on September 3, 2026

Transgender women who want to build a family have more paths available today than in the past, even though carrying a pregnancy in a transplanted uterus remains experimental and is not yet an established clinical treatment anywhere in the world. For transgender women, the most reliable and widely available routes to parenthood involve fertility preservation, use of a partner’s or donor’s eggs, and working with a gestational carrier.

Fertility Preservation Before Transitioning

Sperm banking, or cryopreservation, before starting hormone therapy or having gender-affirming surgery is the most well-established option for transgender women who may want biological children later in life. Hormone therapy can significantly reduce sperm production over time, so fertility preservation done in advance keeps that option open without requiring a pause in transition-related care. Sperm samples can be stored for many years and used later with a partner’s eggs, donor eggs, and a gestational carrier.

Building a Family With Donor Eggs and a Gestational Carrier

Many transgender women build their families by combining preserved or freshly collected sperm with eggs from a partner or an egg donor, then transferring the resulting embryo to a gestational carrier. This path allows for a genetic connection to the child through the sperm, while a surrogate carries the pregnancy to term. In vitro fertilization is used to create the embryo before transfer.

The Current State of Uterus Transplant Research

Uterus transplantation has enabled a small number of successful pregnancies in cisgender women born without a functioning uterus, and researchers have discussed whether the procedure could eventually be adapted for transgender women. However, this remains an area of active medical research rather than a proven or available treatment. Adapting the procedure for transgender women raises additional surgical and immunological questions that have not yet been resolved in clinical practice, and no established protocol currently exists. Anyone interested in this area of research should rely on peer-reviewed medical literature and speak with a specialist rather than treating it as a currently available option.

Talk to a Fertility Specialist About Your Options

Every path to parenthood looks different, and the right option depends on your individual circumstances, timeline, and goals. At Chedid Grieco, our team has nearly 30 years of experience helping patients build families through fertility preservation, IVF, and third-party reproduction. Contact us to discuss which options may be right for you.

Frequently Asked Questions About Family-Building for Transgender Women