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Review
. 2020 May 4;21(9):3245.
doi: 10.3390/ijms21093245.

Human Ovarian Cortex biobanking: A Fascinating Resource for Fertility Preservation in Cancer

Erica Silvestris  1 , Giuseppe De Palma  2 , Stefano Canosa  3 , Simone Palini  4 , Miriam Dellino  1 , Alberto Revelli  3 , Angelo Virgilio Paradiso  2
Affiliations
Review

Human Ovarian Cortex biobanking: A Fascinating Resource for Fertility Preservation in Cancer

Erica Silvestris et al. Int J Mol Sci. .

Abstract

Novel anti-cancer treatments have improved the survival rates of female young patients, reopening pregnancy issues for female cancer survivors affected by the tumor treatment-related infertility. This condition occurs in approximately one third of women of fertile age and is mainly dependent on gonadotoxic protocols, including radiation treatments. Besides routine procedures such as the hormonal induction of follicular growth and subsequent cryopreservation of oocytes or embryos, the ovarian protection by gonadotropin-releasing hormone (GnRH) agonists during chemotherapy as well as even gonadal shielding during radiotherapy, other innovative techniques are available today and need to be optimized to support their introduction into the clinical practice. These novel methods are hormone stimulation-free and include the ovarian cortex cryopreservation before anti-cancer treatments and its subsequent autologous reimplantation and a regenerative medicine approach using oocytes derived in vitro from ovarian stem cells (OSCs). For both procedures, the major benefit is related to the prompt recruitment and processing of the ovarian cortex fragments before gonadotoxic treatments. However, while the functional competence of oocytes within the cryopreserved cortex is not assessable, the in vitro maturation of OSCs to oocytes, allows to select the most competent eggs to be cryopreserved for fertility restoration.

Keywords: cryopreservation; gonadotoxicity; oncofertility; ovarian cortex; ovarian stem cells; tissue biobanking.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Anatomic location and structure of the ovary including cortical components.
Figure 2
Figure 2
Potential applications of whole ovary and cortex fragments cryopreservation and transplantation for fertility preservation.
Figure 3
Figure 3
Live birth rates obtained by traditional oocyte pick-up and cryopreservation (left) and novel techniques using ovarian cortex biopsies (right), as reported in literature.
Figure 4
Figure 4
In vitro maturation of ovarian stem cells (OSC)s to oocyte-like cells (OLCs) of large (red arrows) and small (black) size in three weeks cultures.
See this image and copyright information in PMC

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