Fertility options
Brief context: I am a trans woman in her early 30s who has been on HRT since I was 14. Initially I was taking oral estrogen and spiro, but after around 9 months or a year I switched over to CPA (12.5mg per day or every other day), which I dutifully continued to use for a decade before switching to EV mono therapy.
Last year I finally had my consultation for bottom surgery and I knew that I would have to cease HRT so I can bank sperm as I've always wanted to be a mother and I would prefer to have biological children. 7.5 months later I still have azoospermia.
My hormone levels have been solidly in the male range for most of that time. At the end of December my T, LH, and FSH were all in the upper end of the male range and my E was very low. I was hopeful that I would be able to bank soon and resume HRT ASAP, but screenings in both February and May confirmed that I don't have any sperm.
I asked my doctor about clomid and he told me that it would make no sense in my case as my hormones are where they need to be. The way he tells it, there's nothing that could be done aside from playing the waiting game. Meanwhile T is masculinizing my body and face and I am very upset about that.
The additional options as my doctor related to me are ESSM (expensive, seems unlikely if they're not finding anything after centrifuging), or TESE (expensive, invasive). He also says that I could have testicular tissue frozen if we get to a point where stem cells can be turned into gametes, but that seems like a moonshot at the moment.
Parenthood is very important to me and I want to get samples. I am willing to tolerate the discomfort if it means I can do what I set out to do. But I really would like to see what my options are at this stage. I worry that I might have broken my reproductive system with my aggressive and early intervention, or perhaps I was never fertile at all and it would be good to know if anything could be done to provide clarity on that.