Research on the Impact of Gonadotoxic Therapy

Individuals receiving gonadotoxic therapies due to oncologic, rheumatologic conditions, as well as transgender individuals undergoing puberty suppression and followed by cross-sex hormones may develop gonadal dysfunction and benefit from fertility preservation. To date, however, the risk/benefit analysis of fertility preservation has not been fully elucidated as the gonadotoxicity of many of these medications have not been well studied.

  • Clinical Databases: The NICHD-PAG program has performed over 75 ovarian tissue cryopreservation procedures for individuals receiving gonadotoxic therapy at Children’s National. A database with detailed endocrine, medical epidemiologic and follow-up questionnaires is housed at Children’s National). In addition, Dr. Gomez-Lobo is involved through the Oncofertility Consortium in the creation of a national clinical database of individuals who underwent fertility preservation.
  • Through collaborations with researchers within the National Cancer Institute we are evaluating the effects of newer agents on gonadal function. Mouse CartT
    • Mice CAR-T cell project: Chimeric Antigen Receptor (CAR) T-cell therapy is a promising treatment for patients with many types of blood cancer, including leukemia and lymphomas. It is a highly specialized therapy that involves genetically modifying a patient's own T cells to attack their cancer cells. Patients with CAR-T cell therapy experience immune related side effects and neurotoxicity has been well documented. However, its effect on female reproductive system has not been explored. Our lab is interested in understanding the effects of CAR-T treatments on ovarian follicular development/growth in AML and ALL tumor mice models. These tumor mice models will provide more insights into how the tumor micro-environment itself disrupts the ovarian folliculogenesis. Using different molecular genomics approaches (RNA-seq) and multiplex IHC, we would also like to explore how immune cells interact with stromal environment and other cell types of follicles inside the ovary.
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