For the first time, scientists have created artificial ovarian tissue that preserves both structure and function. The achievement opens new possibilities for understanding and one day protecting women’s fertility during cancer treatment.
When 28-year-old Maria learns that she must undergo chemotherapy, a storm of questions fills her mind. The treatment is vital, but she cannot stop thinking about what it will mean for her future. The risk of losing her fertility feels almost heavier than the disease itself. Her doctor has no clear answer, since science still lacks a reliable method to predict how ovaries respond to cancer treatment on an individual level.
The ovary is like a finely tuned orchestra. Support cells, hormones, and blood vessels must all play together in harmony to help the tiny sacs called follicles grow eggs. If even one instrument falls out of tune, the whole performance can break down.
Until now, no one has managed to recreate this environment outside the human body. Existing models have either been too simple, too unstable, or built on cells that fail to behave like true ovarian tissue.
A team from Karolinska Institutet in Stockholm, Sweden; biotech company BioLamina AB, headquartered in Sundbyberg, Sweden; and the Technical University of Denmark in Kongens Lyngby has now succeeded in creating artificial tissue that can survive in the laboratory for up to six weeks. Made from silk, the tissue is stable enough to support the structures where eggs develop, an essential prerequisite for fertility.
At the head of the project is fertility researcher Valentina Di Nisio. She sees far-reaching implications in the results: “The silk scaffold could become crucial for women facing fertility-threatening treatments such as cancer therapy,” says Di Nisio. “Our goal is to move toward personalized fertility medicine, using the tissue to predict how an individual woman’s ovary will respond and perhaps help her even before treatment begins.”
Why Biosilk changes everything
The breakthrough may sound straightforward, but the road to success was long and filled with obstacles. The greatest challenge was to find a material that could not only keep ovarian cells alive but also coax them into working together in three dimensions as they do inside the body.
Earlier attempts quickly fell short, Di Nisio explains. Standard cell cultures grown flat on plastic were too simple to mimic ovarian function. Spontaneously forming three-dimensional structure from ovarian cells – called spheroids – looked promising at first. But as soon as they were tested, they crumpled like a sandcastle hit by a wave. Even standardized gel constructs failed to position cells correctly or enable them to communicate.
The setbacks left the team frustrated, until they tested a special type of biosilk developed by BioLamina.
“The silk offered something none of the other materials could. It gave the cells a surface to cling to, and they began to organize as we had hoped,” says Di Nisio. Under the microscope, the silk appeared as a fine thread, with cells lining up side by side and forming a tissue-like structure. “For the first time, we saw tissue take shape that actually had the potential to function like an ovary. That was the turning point that gave us the courage to move forward.”
Building life from a thread
The researchers started by isolating support cells from ovarian tissue donated by 5 patients. They placed the cells within a network of silk fibers, porous enough to let nutrients flow through but strong enough to provide physical support. Within days, the cells began layering and forming patterns reminiscent of blood vessels and connective tissue.
At the same time, the cells started producing hormones. The Biosilk tissue even produced very low levels of the female hormone estrogen and kept doing this for six weeks straight. For Di Nisio, this was clear evidence that the tissue was not only alive but functioning as an ovary.
“We quickly saw that the tissue was performing the tasks essential for resembling an ovarian environment. It produced hormones and created an environment potentially capable of supporting egg development,” she notes, adding that the tissue supported follicles presence for up to three weeks without signs of morphological degeneration, much longer than any previous experiment had achieved.
Testing cancer treatments on artificial ovarian tissue
The results point in two directions. First, they show that silk can be used to create artificial ovarian tissue that remains stable and functional for extended periods. Second, they suggest that the tissue could serve as a platform for testing therapies.
The team has already studied how the tissue responds to radiation. The cells survived, but they lost the ability to create a three-dimensional environment.
“That is an important finding,” says Di Nisio. “It shows why it is essential to take precautions before cancer treatment begins.”
These results have been submitted for publication and are currently under peer review.
Personalised fertility care on the horizon
More studies are already in the pipeline. The silk-based ovarian tissue, Di Nisio explains, could one day make fertility care far more tailored than it is today. The vision is that doctors might take a biopsy from a patient, culture her cells on the silk scaffold, and test different treatments before therapy even starts.
The same approach could also be used to evaluate new drugs and environmental chemicals for their impact on women’s fertility. Animal testing has long been the standard, but differences between species make the results uncertain. Using real human cells on a silk scaffold could give scientists a much clearer picture than relying on animals, whose bodies don’t always react like ours.
The researchers are now refining the method so it can be used more widely in laboratories and, eventually, in clinics. More patients have already donated tissue, and many more are expected to contribute.
The dream of a lab-grown ovary
The next phase is to integrate follicles more deeply into the artificial tissue so they can survive longer than the three weeks achieved so far. If this is successful, the team will extend the work to cells from women of different ages and diagnoses to refine the model toward an even closer resemblance of the natural ovary. Such an advance could make a real difference for women who otherwise have no chance of preserving their fertility.
“It is still early, but we are beginning to see the outlines of something that could become very significant,” says Di Nisio. She is motivated by the hope of helping women already burdened by a life-threatening illness to keep the possibility of having a child alive.
“This breakthrough is the culmination of ten years of work. I have studied fertility since my PhD, first with mouse models and cell lines, later with human tissue. I have seen all the limitations of earlier models. My aim has always been to do research that does not remain in the lab but can make a difference in women’s lives,” she says.
The next step will be to carry out studies based on cells from diverse cohorts of women covering various diagnoses and age ranges, and to refine the model to an even closer resemblance of the ovary structure and function.
