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VOLUME 2 - NUMBER 3 - 2025

Overview of fertility preservation for oncology patients and advanced medicinal product therapy application

  • Gabriella Zito, Martina Palmieri, Chiara Agostinis, Andrea Balduit, Roberta Bulla, Giuseppe Ricci
  • Concise review, 08-12
  • Full text PDF

  • Recent advances in cancer therapy have significantly increased survival rates among pediatric and adolescent patients, highlighting the need to address long-term effects such as infertility caused by gonadotoxic treatments. Ovarian tissue cryopreservation (OTC) has emerged as a vital fertility preservation strategy, particularly for prepubertal patients or those requiring immediate chemotherapy. While oocyte and embryo cryopreservation remain the gold standard for postpubertal women, OTC offers the only viable option for prepubertal patients and those with hormone-sensitive cancers. Despite over 200 reported live births following ovarian tissue Autotransplantation (OTT), clinical success is still limited by post-transplant ischemic injury and potential malignant cell reintroduction. To mitigate these risks and improve graft viability, recent bioengineering approaches focus on enhancing graft revascularization through the use of endothelial cells (ECs) and biocompatible 3D scaffolds. In a novel study by Spazzapan et al., ECs isolated from ovarian tissue were expanded in a GMP-compliant bioreactor and combined with a collagen-based dermal scaffold (Integra) to form an advanced therapeutic medicinal product (ATMP). This construct was tested in a murine model and showed enhanced vascularization of the graft, suggesting a promising strategy to improve ovarian graft function. These innovative approaches offer hope for improving fertility outcomes in young cancer survivors, although further clinical validation is needed before application inhuman trials.

  • KEY WORDS: Oncofertility preservation, OTT, ATMPs.