Studies of the Physiopathology of the Ovary

Oncofertility

1) “Oncofertility: Development of new therapeutic strategies to prevent damage to ovarian function induced by chemotherapeutic drugs and/or radiotherapy in young patients with cancer”

It is estimated that 1 in 50 women are diagnosed with cancer before the age of 39. In addition, the number of children suffering from this disease has increased in recent years. In Argentina, 1,400 cases per year are expected (450 among girls aged 5 to 15).

Premature ovarian failure (POF) can be caused by treatments with chemotherapeutic drugs or radiotherapy and therefore, causing infertility in young patients. Chemotherapeutic drugs have a strong toxic effect on the ovary, affecting both the oocyte and the follicular cells.

2) “Pathophysiological mechanisms of ovarian angiogenesis in PCOS”.

Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. This syndrome is characterized by both endocrine, metabolic and reproductive alterations, producing a decrease in fertility. For all this, the treatments that are currently applied, both for metabolic syndrome and infertility, are not efficient in all patients and are continuously reviewed and agreed upon worldwide. One of the characteristics of this syndrome is an alteration in ovarian angiogenesis. Therefore, another of the objectives of our laboratory is to study the pathophysiological mechanisms of ovarian angiogenesis in PCOS in order to provide knowledge about the etiology of the disease and design new therapeutic strategies to improve fertility in these patients. We also aim to understand the mechanism of action of currently applied treatments in order to improve and personalize their application for greater efficacy (Di Pietro et al., 2020; Di Pietro et al., 2018; Di Pietro et al., 2016).

3) “Metabolic Syndrome and alteration of female fertility: ovarian pathophysiology and therapeutic approach”.

The adverse effects of metabolic syndrome on female fertility have been partially studied and the results are controversial. An alteration in the expression of genes in the ovary, an alteration in ovarian miRNAs and alterations in the hypothalamic-pituitary-gonadal axis have been proposed. However, it is widely accepted that the alterations in female fertility caused by this syndrome are multifactorial and more than one mechanism would be involved. Based on these considerations, our objective is to evaluate the effects of the metabolic syndrome on the functionality of the ovary and on female fertility.

4) “”Reproductive impact in patients recovered from COVID-19: effects of SARS-COV2 on female fertility””.

In the female reproductive system, ACE-2 (major receptor for SARS CoV-2) is expressed in the uterus, vagina, placenta, and ovary. In particular, ACE-2 have been detected in the ovaries of women of reproductive age and postmenopausal. In the human ovary, both stromal and granulosa cells have been shown to be positive for ACE-2. ACE-2 is known to regulate follicular development and ovulation, ovarian angiogenesis, endometrial changes, and embryonic development. Based on these considerations, ACE-2 plays a key role in the regulation of fertility, and the SARS-CoV-2 virus could damage the ovarian vasculature and affect the functionality of the follicular cells. So far, there is no study showing that the virus binds to ACE-2 receptors in the ovary, and what effects, if any, this infection would have on ovarian function, oocyte quality, and reproductive success. Recently, in our laboratory, we have shown for the first time that SARS-CoV-2 infection in women affects the follicular microenvironment (place where the oocyte grows), disregulating ovarian function (Herrero et al., 2021).