It may be possible to rejuvenate ovaries after chemotherapy without the need for surgery, after the fertility of female mice was successfully restored following injections of donor cells.
The approach involves injecting either stored or donated follicles 鈥� the cells in ovaries that contain and eventually release egg cells 鈥� into the ovaries. The technique is 鈥渁ble to rejuvenate the potential of聽the ovary using donated follicles鈥� and could 鈥減rolong the fertility of women鈥�, says Michael Dahan at McGill University in Montreal, Canada, who wasn鈥檛 involved in the work.
Some cancer treatments can affect the supply of eggs, and may聽make it more difficult to conceive after treatment. People undergoing these treatments may have pieces of their ovary removed and frozen beforehand, in order to聽preserve their fertility. These tissues can then be surgically reimplanted if someone wants to聽get pregnant. Over 130 babies have been born following this type聽of procedure.
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But the approach is still new, and some doctors worry about the risk of reimplanting cancer cells. 鈥淚f a woman has ovarian cancer or聽leukaemia, you wouldn鈥檛 want to put that tissue back in,鈥� says Kyle Orwig at the University of聽Pittsburgh in Pennsylvania. 鈥淭he聽worst thing you can do is give聽cancer back to a survivor.鈥�
Orwig and his colleagues have聽developed a different approach. Instead of implanting ovary tissue, the team only implants the follicles. This should avoid implanting any cancer cells, says Orwig.
To test the approach, the team gave four female mice varying doses of two chemotherapy drugs that Orwig says cause infertility in humans. The team then collected follicles from donor mice who hadn鈥檛 undergone chemotherapy and injected them into the ovaries of the female mice that had.
Two of the four mice later gave birth to pups, some of which had features of the donor, rather than those of their parents. This led the team to be sure that it had been the injection of follicles that had resulted in pups with the same features.
Orwig thinks the approach could also be used to inject women with their own stored follicles. 鈥淵ou wouldn鈥檛 need a surgical procedure,鈥� he says. Instead a procedure similar to one already used to collect eggs for IVF, where a needle is used to access the ovaries via the vagina, could be used. 鈥淚nstead of taking eggs out, you could inject follicles,鈥� he says.
The follicles could also be taken from donors, says Dahan, and they might be easier to obtain than donor eggs. And while people who receive donated organs need to take drugs to suppress the immune system, those who receive follicles might not need to聽as 鈥渢here is a minimal risk of rejection鈥�, says Dahan.
In theory, the approach could be聽used in humans straight away, says Orwig. Regulatory bodies allow a person鈥檚 own cells to be reinjected into them if they have only been exposed to 鈥渕inimal manipulation鈥�. But Orwig says his聽next step will be to trial it in monkeys first.
There are still questions that need to be answered. We don鈥檛 know how infertile the mice were before the treatment, and whether the technique would work if the mice had no ovaries, for example.聽
鈥淚t is a unique approach, and the concept is interesting,鈥� says Monica Laronda at Northwestern University in Chicago. 鈥淏ut there is definitely more [work] that I would like to see.鈥�
Reference: bioRxiv,
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