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Updated: Feb 3, 2026

Fertility Preservation Through Oocyte Vitrification: Clinical and Laboratory Perspectives
Published on: September 16, 2021
Müllerian inhibiting substance/anti-Müllerian hormone as a fertility preservation agent
David Pépin1,2, Mary E Sabatini3, Patricia K Donahoe1,2
1Pediatric Surgical Research Laboratories, Massachusetts General Hospital, Boston.
Purpose Of Review:
The nascent field of oncofertility is quickly gaining traction as novel experimental treatments are being developed, driving a renewed interest in Müllerian inhibiting substance (MIS) as an ovarian fertoprotectant.
Recent Findings:
MIS is unique in its mechanisms of ovarian protection by virtue of acting directly on granulosa cells of primordial follicles and for being a benign reproductive hormone, with few side effects. We will explore in this review how it may be utilized to protect the ovary from chemotherapy, or to enhance ovarian tissue cryopreservation therapy. We will also examine potential mechanisms of action of MIS across multiple cell types, as well as current limitations in our understanding of the pharmacology of recombinant MIS.
Summary:
The usefulness of MIS as a fertoprotectant may be dependent on the mechanisms of gonadotoxicity of each chemotherapeutic. Further investigation is needed to determine how to best deliver and combine MIS treatment to existing fertility management strategies.
Insights
Müllerian inhibiting substance (MIS) shows promise as an ovarian fertoprotectant, protecting against chemotherapy and enhancing cryopreservation. Further research is needed to optimize its use in fertility preservation strategies.
Area of Science:
- Reproductive Endocrinology
- Oncofertility
- Cellular Biology
Background:
- Oncofertility is an emerging field focused on preserving fertility in cancer patients.
- Müllerian inhibiting substance (MIS) is gaining attention for its potential role in ovarian protection.
Purpose of the Study:
- To review the potential of MIS as an ovarian fertoprotectant.
- To explore MIS mechanisms in protecting against chemotherapy and enhancing cryopreservation.
- To examine limitations in recombinant MIS pharmacology.
Main Methods:
- Literature review of experimental treatments and mechanisms of MIS.
- Analysis of MIS action on granulosa cells and primordial follicles.
- Evaluation of MIS potential in chemotherapy-induced gonadotoxicity and ovarian tissue cryopreservation.
Main Results:
- MIS acts directly on granulosa cells of primordial follicles.
- MIS is a benign reproductive hormone with minimal side effects.
- Potential applications include protection from chemotherapy and enhanced ovarian tissue cryopreservation.
Conclusions:
- The efficacy of MIS as a fertoprotectant may vary depending on the chemotherapeutic agent.
- Further research is required to optimize MIS delivery and integration with current fertility management strategies.
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