Site:  University of Pennsylvania

Principal Investigator:  Christos Coutifaris, MD, PhD

Rationale

In recent years, cancer diagnosis has changed, in many cases, from a death sentence to a disease with many survivors.  Aggressive cancer treatments, although successful with respect to survival, may result in damage or loss of oocytes and impairment or loss of fertility.  The purpose of the Oncofertility Consortium is to address the issue of fertility preservation in cancer patients with sufficiently trained physician-scientists who will implement the research and clinical agenda required to treat their patients with new and emerging technologies.   

This multidisciplinary force of oncofertility specialists, specifically equipped to cope with the fertility concerns of patients with cancer, represents a new discipline in the field of Women’s Health.  Long-term success will depend on how well the development of this global workforce is orchestrated, supported, and focused.  It is the intent of this project to train and educate the first generation of oncofertility specialists in research related directly to the reproductive needs of the cancer patient and survivor.  Education and training programs will facilitate the development of the oncofertility discipline that exists at the intersection of oncology, pediatrics, reproductive science and medicine, biomechanics, material science, mathematics, social science, bioethics, religion, policy research, reproductive health, law, and cognitive and learning science. 

Specifically, this program will train and fund both NRSA eligible and non-NRSA eligible trainees through 2 different NIH grant mechanisms.  Oncofertility training will merge entirely with the clinical and education objectives of the fellowship training program, Reproductive Endocrinology and Infertility (REI).  Therefore, the likely source of oncofertility specialists will come directly from within the ranks of the REI subspecialty fellowships for advance training after completion of a residency in Obstetrics and Gynecology.     

The objectives of this program are to:

  • Expand the training of oncofertility specialists within REI programs across the nation through a rigorous educational, laboratory-based, and research curriculum.
  • Seek federal funding for additional training dedicated to laboratory work and research related to oncofertility.

Indices of Scholarship 

  • Train fellows in cellular and molecular approaches to reproductive biology relevant to oncofertility and the responsible conduct of research
  • Require the completion of additional didactic training and an online educational module
  • Provide clinical exposure to adult and pediatric oncology patients who face the prospect of fertility loss or compromise
  • Participate in an academic enrichment program consisting of seminars, lecture series, journal clubs, conferences, and retreats geared towards a comprehension of the interdisciplinary nature of oncofertility

Trainees To Date

  • Dr. Monica Mainigi trained at Northwestern in the isolation and culture of early and secondary mouse follicles. The objectives of her research entitled “Developmental Competence of the Mammalian Oocyte: Studies Utilizing an in vitro Model of Follicular Maturation” were (1) To compare the nuclear and developmental competence of oocytes grown at physiologic oxygen (5%) versus atmospheric oxygen (20%) in a three dimensional follicle system, (2) to investigate to effect of in vitro follicle culture on gene expression in the fully grown oocyte and (3) to determine if the culture of immature follicles in vitro leads to disruption of events necessary for successful oocyte activation and fertilization.
  • Dr. Fanzhen Hong trained at the University of Pennsylvania in the isolation and culture of early and secondary mouse follicles. Dr. Hong’s main laboratory training initiative was to gain expertise in the isolation and culture of mouse preantral follicles and participate in all the didactic initiatives of the Division of Reproductive Endocrinology and Infertility. Arrangements are currently being made between our program and her University to provide the necessary guidance for setting up a clinical Oncofertility program in the Province of Shandong in China.
  • Dr. Shiying Jin trained and gained expertise in the isolation and culture of early secondary mouse follicles at Northwestern University. Dr. Jin’s focus during the training period was to gain expertise in the isolation and culture of mouse preantral (early secondary) follicles and initiate studies to optimize the cryopreservation and in vitro culture system for the culture of human follicles.
  • Dr. Jayon Kim is training at the University of North Carolina, Chapel Hill with Dr. Jennifer E. Mersereau. Dr. Kim is involved in a variety of studies including trials evaluating the efficacy of oocyte cryopreservation; the complex relationships between BRCA mutations, breast cancer, and reproductive hormones, and more. Read one of her recently published papers
  • Additional trainees will be accepted annually as the program continues

 

Consortium Support and Impact

This project will draw on the biomedical and clinical research of the Oncofertility Consortium.  Fellows will be trained in cryopreservation techniques and storage, follicle growth research in primates, the effects of cancer treatment on women’s reproductive capacities and the growth and maturation of human follicles, and tissue engineering applications.  Each fellow will be expected to receive instruction in bio-psychosocial science, bioethics and religion, and reproductive health policy and law related to oncofertility.  Online Resources will provide additional information to those being trained to ensure the optimal educational environment.  Currently, there are 3 projects (see Fertility Measures After Cancer and Pilot Project Program) funded through the Consortium and being led by members of the first generation of oncofertility specialists, who use and provide feedback on the education and training program. 

This research was supported by the Oncofertility Consortium®, funded by the National Institutes of Health through the NIH Roadmap for Medical Research, Grant UL1DE19587 and TL1CA133837/RL9CA133838.