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Challenges in Fertility Preservation
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Challenges in Fertility Preservation

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Reproductive Medicine & Andrology".

Deadline for manuscript submissions: 20 November 2025 | Viewed by 876

Special Issue Editors

Dr. Loris Marin

E-Mail Website
Guest Editor
Department of Women’s and Children’s Health, University of Padua, 35128 Padua, Italy
Interests: cervical cancer prevention; gynaecological surgery; endometriosis; laparoscopic surgery; reproductive medicine; fertility preservation; cryopreservation
Prof. Dr. Guido Ambrosini

E-Mail Website
Guest Editor
Department of Women’s and Children’s Health, University of Padua, 35128 Padua, Italy
Interests: reproduction; fertility preservation; endocrinological gynecology; oncological gynecology; prenatal medicine

Special Issue Information

Dear Colleagues,

Survival rates after cancer treatment have increased due to advances in oncology. However, oncological treatments such as surgery, chemotherapy, and radiotherapy can be gonadotoxic and can reduce fertility. Ovarian reserves can be damaged by oncological treatments, resulting in drastic reduction in fertility. For this reason, women diagnosed with cancer should be referred to IVF centers before starting gonadotropic therapies, since having children is an important factor in the quality of life overall.

The gold standard technique in fertility preservation is oocyte and/or embryo cryopreservation, depending on the age of the patient, the woman’s desire, the presence of a partner, and the law of the country in question. The experimental label for cryopreservation and ovarian tissue auto-transplantation in fertility preservation was removed in December 2019 by the American Society of Reproductive Medicine. This procedure is the only feasible fertility preservation technique in prepubertal girls and in women who cannot delay the start of oncological treatments. Research on this procedure has come to concern issues involving increasing the longevity of transplanted tissue and avoiding the potential risk of neoplastic cell reintroduction. In particular, studies are presently focused on research into ovarian stem cells, in vitro ovarian follicle growth, and artificial ovaries.

The aim of this Special Issue of the Journal of Clinical Medicine is to report the latest research on oncofertility and fertility preservation techniques. We aim to attract original research articles and reviews on the latest updates in oncofertility and fertility preservation, with the larger aim of improving clinical outcomes and ensuring optimal short- and long-term management.

Dr. Loris Marin
Prof. Dr. Guido Ambrosini
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • fertility preservation
  • oocytes cryopreservation
  • embryo cryopreservation
  • ovarian tissue transplantation
  • gonadotoxic therapy

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Published Papers (2 papers)

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Research

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17 pages, 5672 KiB  
Article
The Effect of Dienogest on Deep Endometriosis Nodules Involving the Recto-Sigmoid Colon: A Prospective Longitudinal Long-Term Study
by Carlos Andrés Contreras, Ignacio Brunel, Mónica Restrepo, Claudia Patricia Franco, María Clara Soto, José Carlos Vilches, Rodrigo Orozco, Stefano Guerriero and Juan Luis Alcázar
J. Clin. Med. 2025, 14(14), 5164; https://doi.org/10.3390/jcm14145164 - 21 Jul 2025
Viewed by 570
Abstract
Objective: To assess the long-term effects of Dienogest on clinical complaints and nodule sizes in women affected by recto-sigmoid deep endometriosis (DE). Methods: This was a single-center longitudinal prospective observational study comprising a consecutive series of women affected by recto-sigmoid DE, who underwent [...] Read more.
Objective: To assess the long-term effects of Dienogest on clinical complaints and nodule sizes in women affected by recto-sigmoid deep endometriosis (DE). Methods: This was a single-center longitudinal prospective observational study comprising a consecutive series of women affected by recto-sigmoid DE, who underwent medical treatment with Dienogest (2 mg daily continuous). All women underwent clinical visits and transvaginal sonography (TVS) with bowel preparation prior to starting therapy and at 3–6-month intervals for at least 12 months. Clinical complaints such as dysmenorrhea, dyspareunia and dyschezia were assessed using a visual analog scale (VAS). The DE recto-sigmoid lesion was measured in the three orthogonal planes. The lesion’s volume was estimated using the prolate ellipsoid formula. The maximum diameter and lesion volume were used for analysis. Patients’ complaints and lesion sizes before starting the treatment and at final follow-up were compared. Results: From January 2017 to July 2020, 125 patients were consecutively recruited (mean age: 37 years, ranging from 20 to 50 years). The median follow-up period was 47.8 months (range: 12–74 months). We did not observe a significant correlation between the severity of the symptoms and the lesion size prior to starting therapy. Clinical complaints improved significantly during treatment (88% of women were symptomatic at initial visit, versus 53% at final follow-up, p < 0.001). The median lesion volume significantly decreased (median initial volume vs. final volume: 1.1 mL vs. 0.9 mL, p = 0.017). However, the median maximum lesion diameter did not change significantly (26.0 mm vs. 25.0 mm, p = 0.779). Conclusions: Long-term Dienogest therapy significantly relieves clinical symptoms related to recto-sigmoid DE. This is accompanied by a significant reduction in the lesion volume but not the maximum lesion diameter. Full article
(This article belongs to the Special Issue Challenges in Fertility Preservation)
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Review

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16 pages, 813 KiB  
Review
Beyond Earth, Beyond Time: Preserving Female Fertility in Space Missions
by Loris Marin, Luciana Bordin, Chiara Sabbadin, Guido Ambrosini and Alessandra Andrisani
J. Clin. Med. 2025, 14(17), 5975; https://doi.org/10.3390/jcm14175975 (registering DOI) - 24 Aug 2025
Abstract
The number of female astronauts participating in space missions is increasing, and concerns about the impact of spaceflight on reproductive health have emerged. Space radiation and microgravity pose potential threats to ovarian reserve and uterine function, but data on human female reproductive health [...] Read more.
The number of female astronauts participating in space missions is increasing, and concerns about the impact of spaceflight on reproductive health have emerged. Space radiation and microgravity pose potential threats to ovarian reserve and uterine function, but data on human female reproductive health in space remain scarce. This review explores current evidence from both real and simulated space conditions, including animal studies and ground-based cosmic radiation models. The relevant literature on cosmic radiation, fertility preservation strategies, and gynecological risk management in spaceflight was analyzed to provide a comprehensive synthesis. Space radiation might damage ovarian follicles and impair folliculogenesis, potentially leading to premature ovarian failure and microgravity might alter endocrine function. While human data are lacking, murine and in vitro model studies suggest significant reproductive risks. Embryo/oocyte and ovarian tissue cryopreservation are currently the most viable fertility preservation strategies. Shielding technologies, radioprotective agents, and hormonal modulation may offer adjunct protection. In conclusions, fertility counseling and preservation should become integral to pre-mission planning for female astronauts of reproductive age. A personalized approach, accounting for individual reproductive goals, age and mission duration, is essential. Further research is urgently needed to understand the reproductive effects of deep space travel and to develop targeted protective strategies. Full article
(This article belongs to the Special Issue Challenges in Fertility Preservation)
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