In Vitro Gametogenesis in Oncofertility: A Review of Its Potential Use and Present-Day Challenges in Moving toward Fertility Preservation and Restoration

Abstract

Current fertility preservation options are limited for cancer survivor patients who wish to have their own biological children. Human in vitro gametogenesis (IVG) has the hypothetical ability to offer a unique solution to individuals receiving treatment for cancer which subsequently shortens their reproductive lifespan. Through a simple skin punch biopsy, a patient’s fertility could be restored via reprogramming of dermal fibroblast cells to induced pluripotent stem cells, then from primordial germ cell-like cells into viable oocytes and spermatocytes which could be used for embryogenesis. Induced pluripotent stem cells could also be used to form in vitro environments, similar to the ovary or testes, necessary for the maturation of oogonia. This would allow for the entire creation of embryos outside the body, ex vivo. While this area in stem cell biology research offers the potential to revolutionize reproduction as we know it, there are many critical barriers, both scientific and ethical, that need to be overcome to one day see this technology utilized clinically.

The journey of a generation: advances and promises in the study of primordial germ cell migration

“…Since Hayashi and Saitou's breakthrough generation of mouse PGCLCs and gametes ( Hayashi et al, 2011 , 2012 ), protocols have been developed to improve PGCLC survival and the efficiency of derivation ( Overeem et al, 2023 ; Jo et al, 2022 ; Gell et al, 2020 ). PGCLCs are key to achieving translational goals, such as the preservation of endangered species and reproductive medicine ( Hayashi et al, 2022 ; Wesevich et al, 2023 ). Other studies have more fundamental goals, such as to increase the number of model organisms used for scientific discovery ( Jung et al, 2019 ; Seita et al, 2023 ) or to understand the underlying logic of human germline development ( Saitou and Hayashi, 2021 ; Saitou, 2021 ; Irie et al, 2015 ; Gafni et al, 2013 ; Overeem et al, 2023 ).…”

Anticipating in vitro gametogenesis: Hopes and concerns for IVG among diverse stakeholders

“…The in-depth qualitative data discussed here identify novel points of interest in and concern for IVG among potential beneficiaries. Future empirical studies should compare our findings to attitudes toward IVG among other groups of potential users, such as oncofertility patients ( Mertes and Pennings, 2022 ; Wesevich et al., 2023 ), and the general public. This qualitative data also pave the way for larger survey-based quantitative studies that could examine the generalizability of these findings in a larger population sample.…”

Whether and How We Will Continue to Reproduce Ourselves

“…As this issue of the JRE explores futures and uncertainties in the field, many ethical and public policy questions in the US and abroad remain about the parameters of acceptable ART usage, including which kinds of persons or couples should be able to access particular treatments or services and why. These uncertainties include whether to hope or fear the future of reproductive technology, which may one day make possible what science fiction can only now imagine, such as gestation through use of artificial wombs (ectogenesis) or the ability to create human sperm or eggs from any cell in a person's body through in vitro gametogenesis (IVG)-a process that has already proved successful in mice (Wesevich et al 2023).…”

“…These uncertainties include whether to hope or fear the future of reproductive technology, which may one day make possible what science fiction can only now imagine, such as gestation through use of artificial wombs (ectogenesis) or the ability to create human sperm or eggs from any cell in a person's body through in vitro gametogenesis (IVG)—a process that has already proved successful in mice (Wesevich et al. 2023).…”