{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:02:01Z","timestamp":1791993721218,"version":"4.4.0"},"reference-count":88,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T00:00:00Z","timestamp":1713484800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>In recent years, immuno-oncology has revolutionized the cancer treatment field by harnessing the immune system\u2019s power to counteract cancer cells. While this innovative approach holds great promise for improving cancer outcomes, it also raises important considerations related to fertility and reproductive toxicity. In fact, most young females receiving gonadotoxic anti-cancer treatments undergo iatrogenic ovarian exhaustion, resulting in a permanent illness that precludes the vocation of motherhood as a natural female sexual identity. Although commonly used, oocyte cryopreservation for future in vitro fertilization and even ovarian cortex transplantation are considered unsafe procedures in cancer patients due to their oncogenic risks; whereas, ovarian stem cells might support neo-oogenesis, providing a novel stemness model of regenerative medicine for future fertility preservation programs in oncology. Recent scientific evidence has postulated that immune checkpoint inhibitors (ICIs) might in some way reduce fertility by inducing either primary or secondary hypogonadism, whose incidence and mechanisms are not yet known. Therefore, considering the lack of data, it is currently not possible to define the most suitable FP procedure for young patients who are candidates for ICIs. In this report, we will investigate the few available data concerning the molecular regulation of ICI therapy and their resulting gonadal toxicity, to hypothesize the most suitable fertility preservation strategy for patients receiving these drugs.<\/jats:p>","DOI":"10.3390\/jpm14040431","type":"journal-article","created":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T04:10:15Z","timestamp":1713499815000},"page":"431","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Fertility Preservation in the Era of Immuno-Oncology: Lights and Shadows"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7415-5986","authenticated-orcid":false,"given":"Erica","family":"Silvestris","sequence":"first","affiliation":[{"name":"Gynecologic Oncology Unit, IRCCS Istituto Tumori \u201cGiovanni Paolo II\u201d Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1071-2058","authenticated-orcid":false,"given":"Stella","family":"D\u2019Oronzo","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Medicine (DIM), University of Bari \u201cAldo Moro\u201d, 70121 Bari, Italy"},{"name":"Division of Medical Oncology, A.O.U. Consorziale Policlinico di Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0562-3579","authenticated-orcid":false,"given":"Easter Anna","family":"Petracca","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Unit, IRCCS Istituto Tumori \u201cGiovanni Paolo II\u201d Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"D\u2019Addario","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Medicine (DIM), University of Bari \u201cAldo Moro\u201d, 70121 Bari, Italy"},{"name":"Division of Medical Oncology, A.O.U. Consorziale Policlinico di Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5745-372X","authenticated-orcid":false,"given":"Gennaro","family":"Cormio","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Unit, IRCCS Istituto Tumori \u201cGiovanni Paolo II\u201d Bari, 70124 Bari, Italy"},{"name":"Department of Interdisciplinary Medicine (DIM), University of Bari \u201cAldo Moro\u201d, 70121 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4006-6421","authenticated-orcid":false,"given":"Vera","family":"Loizzi","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Unit, IRCCS Istituto Tumori \u201cGiovanni Paolo II\u201d Bari, 70124 Bari, Italy"},{"name":"Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6402-6750","authenticated-orcid":false,"given":"Stefano","family":"Canosa","sequence":"additional","affiliation":[{"name":"IVIRMA, Global Research Alliance, LIVET, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8319-6146","authenticated-orcid":false,"given":"Giacomo","family":"Corrado","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Unit, Department of Woman, Child Health and Public Health, Fondazione Policlinico Universitario A. 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