Advancing fertility preservation: structural and functional insights into the human ovary

Abstract

The human ovary plays a vital role in reproduction, serving both as the site for oocyte development and as an endocrine organ that produces steroid hormones essential for fertility and overall health. Female infertility is a widespread condition, arising from factors such as anovulation, ovarian insufficiency, diminished egg quality, and gonadotoxic medical treatments. Although assisted reproductive technologies (ART) and fertility preservation strategies like oocyte vitrification and ovarian tissue cryopreservation (OTC) have improved outcomes for many patients, the field still faces significant challenges. Chief among these are the limited understanding of ovarian biology, particularly the cellular and molecular regulation of folliculogenesis, and the difficulty of supporting full oocyte maturation in vitro. This thesis addresses these challenges by investigating structural, functional, and culture-based strategies to improve ovarian tissue preservation and follicular development, aiming to expand opportunities for diverse patient groups, including cancer survivors and transmasculine individuals.