Beyond Earth, Beyond Time: Preserving Female Fertility in Space Missions

The number of female astronauts participating in space missions is increasing, and concerns about the impact of spaceflight on reproductive health have emerged. Space radiation and microgravity pose potential threats to ovarian reserve and uterine function, but data on human female reproductive health in space remain scarce. This review explores current evidence from both real and simulated space conditions, including animal studies and ground-based cosmic radiation models. The relevant literature on cosmic radiation, fertility preservation strategies, and gynecological risk management in spaceflight was analyzed to provide a comprehensive synthesis. Space radiation might damage ovarian follicles and impair folliculogenesis, potentially leading to premature ovarian failure and microgravity might alter endocrine function. While human data are lacking, murine and in vitro model studies suggest significant reproductive risks. Embryo/oocyte and ovarian tissue cryopreservation are currently the most viable fertility preservation strategies. Shielding technologies, radioprotective agents, and hormonal modulation may offer adjunct protection. In conclusions, fertility counseling and preservation should become integral to pre-mission planning for female astronauts of reproductive age. A personalized approach, accounting for individual reproductive goals, age and mission duration, is essential. Further research is urgently needed to understand the reproductive effects of deep space travel and to develop targeted protective strategies.