Researchers at Yale School of Medicine, under Kutluk Oktay, have developed a minimally invasive laparoscopic procedure to harvest and cryopreserve ovarian cortex containing primordial follicles. Upon reaching menopausal thresholds, the cortical grafts are re-implanted to sustain ovarian function and extend reproductive lifespan.

Key points

• Laparoscopic ovarian cortex retrieval and cryopreservation from Yale trial provides tissue for autologous grafting.
• Low-dose rapamycin by Columbia team inhibits mTOR to slow follicular activation and preserve ovarian reserve.
• Gameto uses engineered ovarian support cells from stem cells in animal models to reduce follicle loss.
• Celmatix develops small molecules targeting follicular atresia pathways to maintain primordial follicle pools.
• Preclinical senolytics and energy-boosting compounds aim to rejuvenate ovarian tissue and restore endocrine function.

Why it matters: These precision strategies represent a paradigm shift in reproductive aging by treating menopause as a modifiable health event rather than an inevitability. Delaying ovarian aging could improve long-term cardiovascular, bone, and cognitive health outcomes, while offering new avenues for preserving fertility and hormonal balance beyond current standards of care.

Researchers at Yale School of Medicine and Columbia University Fertility Center investigate two strategies to delay menopause by targeting ovarian aging. One involves laparoscopic retrieval and cryopreservation of ovarian cortex to preserve primordial follicles; the other tests low-dose rapamycin to inhibit mTOR signaling and slow follicle depletion. These approaches aim to extend reproductive hormone function and reduce menopause-associated health risks.

Key points

• Laparoscopic retrieval and cryopreservation of ovarian cortex tissue preserves tens of thousands of primordial follicles for future transplantation.
• Periodic autografting of thawed ovarian tissue shows anticipated 60–80% follicle survival, potentially sustaining endocrine function for years.
• Weekly low-dose rapamycin administration inhibits the mTOR pathway in ovarian tissue, reducing follicular turnover and preserving ovarian reserve.
• Preclinical mouse and cell models demonstrate slowed ovarian aging and maintained egg quality following mTOR inhibition.
• Ongoing human trials (VIBRANT) assess endocrine markers, follicle counts, and menopausal onset after rapamycin treatment and tissue autografting.

Why it matters: Delaying ovarian aging could transform women’s health by extending hormonal function and reproductive capacity, potentially reducing long-term risks like osteoporosis and cardiovascular disease. These pioneering strategies may establish a new paradigm for managing endocrine aging and improve overall healthspan beyond current hormone replacement therapies.