Basic scientific research on human reproduction and oxidative damage has been extensively performed; however, a more clinical view is still lacking. As a result, exhaustive data on the influence of oxidative stress on human ovarian response and, consequently, on fertility are still lacking. This narrative review aims at summarizing the role of oxidative stress in different conditions associated to female infertility and to list some of the main antioxidant agents. A systematic literature search was performed in May 2022 to retrieve studies regarding the oxidative stress and the human ovarian response from somatic ovarian cells to oocytes damage. Only human studies were included and the authors focused their review, in particular, on clinical implications in order to define a new research perspective on the assessment of any eventual strategy to preserve women’s fertility. Thereby, the authors evaluated the contribution of DNA repair pathways in improving women’s fertility by reducing the DNA damage associated with aging or diseases, such as endometriosis or polycystic ovary syndrome, and eventually, in prolonging the reproductive lifespan after cancer treatment.

Background: Breast cancer (BC) in reproductive-age women raises concerns about fertility preservation, particularly as systemic therapies may compromise ovarian function. Evidence on whether tumor immunohistotype influences ovarian reserve and fertility preservation outcomes remains limited. Methods: We conducted a prospective cohort study of BC patients referred for fertility preservation counseling between November 2020 and May 2025. Ovarian reserve was assessed using anti-Müllerian hormone (AMH) levels and antral follicle count (AFC). Controlled ovarian stimulation (COS) and oocyte cryopreservation were performed according to standardized protocols. Patients were stratified into triple-negative BC (TNBC) and hormone receptor-positive (HR+) and/or HER2+ groups. The primary endpoint was ovarian reserve differences by subtype; the secondary endpoints were ovarian response and oocyte yield. Results: Of 358 patients, 152 were enrolled, and 139 (91.4%) underwent COS, for a total of 145 cycles. The median age was 33 years, median AMH 5.4 ng/mL, and median AFC 17. No significant differences were observed between the TNBC and HR+/HER2+ groups in AMH, AFC, oocyte yield, or mature oocyte rate. Sub-analysis revealed a significantly lower mature oocyte yield in luminal-B tumors. Conclusions: Ovarian reserve and cryopreservation outcomes appeared preserved in TNBC compared with those in patients with HR+/HER2+ BC at diagnosis. These findings provide reassurance that baseline fertility potential is not compromised by tumor immunohistotype.

Background: Preserving fertility in young women with cancer is crucial for comprehensive care. Based on GBD 2023 estimates, approximately 1000 women aged 15–39 are diagnosed with haematological malignancies annually in Italy. Guidelines recommend timely fertility preservation (FP) counselling for all at-risk patients, yet real-world access data remain limited. Methods: This multicentre, retrospective observational study analysed FP counselling for women aged 15–39 with haematological malignancies from 2015 to 2023. Counselling data were extracted from the Italian Assisted Reproductive Technology Registry (IARTR). This data collection system, known as PreFerIta, was developed within a project supported by the Italian Ministry of Health to collect data on Fertility Preservation (FP) treatments in oncology patients and/or those at risk of iatrogenic infertility, provided in seven specialised ART centres across Italy. The PreFerIta database includes data on both oocyte cryopreservation and ovarian tissue cryopreservation. Annual visits were related to the estimated regional incidence of new haematological malignancies (GBD 2023). Counselling-to-incidence ratios, absolute/relative gaps, and 95% confidence intervals (CIs) were calculated. Results: From 2015 to 2023, an estimated 4473 new haematological malignancies occurred in the catchment regions. Concurrently, 1200 FP counselling visits were recorded. While incidence modestly declined, counselling activity remained high. The counselling-to-incidence ratio increased from 17.33% in 2015 to 31.92% in 2018, stabilising between 26% and 31% thereafter (30.98% in 2023). The relative counselling gap decreased from 82.67% to 69.02%. These ratios represent lower-bound estimates of access to specialised oncofertility consultations. Conclusions: In this Italian network, approximately one in four to one in three incident haematological malignancies in young women were associated with specialised FP counselling. This reflects a substantial integration of oncofertility services into haematology care, highlighting opportunities to further strengthen referral pathways and achieve full guideline concordance.