David Pépin1,2, Mary E Sabatini3, Patricia K Donahoe1,2. 1. Pediatric Surgical Research Laboratories, Massachusetts General Hospital, Boston. 2. Department of Surgery, Harvard Medical School, Cambridge. 3. Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Abstract
PURPOSE OF REVIEW: The nascent field of oncofertility is quickly gaining traction as novel experimental treatments are being developed, driving a renewed interest in Müllerian inhibiting substance (MIS) as an ovarian fertoprotectant. RECENT FINDINGS: MIS is unique in its mechanisms of ovarian protection by virtue of acting directly on granulosa cells of primordial follicles and for being a benign reproductive hormone, with few side effects. We will explore in this review how it may be utilized to protect the ovary from chemotherapy, or to enhance ovarian tissue cryopreservation therapy. We will also examine potential mechanisms of action of MIS across multiple cell types, as well as current limitations in our understanding of the pharmacology of recombinant MIS. SUMMARY: The usefulness of MIS as a fertoprotectant may be dependent on the mechanisms of gonadotoxicity of each chemotherapeutic. Further investigation is needed to determine how to best deliver and combine MIS treatment to existing fertility management strategies.
PURPOSE OF REVIEW: The nascent field of oncofertility is quickly gaining traction as novel experimental treatments are being developed, driving a renewed interest in Müllerian inhibiting substance (MIS) as an ovarian fertoprotectant. RECENT FINDINGS:MIS is unique in its mechanisms of ovarian protection by virtue of acting directly on granulosa cells of primordial follicles and for being a benign reproductive hormone, with few side effects. We will explore in this review how it may be utilized to protect the ovary from chemotherapy, or to enhance ovarian tissue cryopreservation therapy. We will also examine potential mechanisms of action of MIS across multiple cell types, as well as current limitations in our understanding of the pharmacology of recombinant MIS. SUMMARY: The usefulness of MIS as a fertoprotectant may be dependent on the mechanisms of gonadotoxicity of each chemotherapeutic. Further investigation is needed to determine how to best deliver and combine MIS treatment to existing fertility management strategies.
Authors: Yi Li; Lina Wei; Marie-Charlotte Meinsohn; Rana Suliman; Maeva Chauvin; Jim Berstler; Kate Hartland; Mark M Jensen; Natalie A Sicher; Nicholas Nagykery; Patricia K Donahoe; David Pepin Journal: Proc Natl Acad Sci U S A Date: 2022-04-05 Impact factor: 12.779