UCLA Life Sciences
For most of the 20th century, a cancer diagnosis for a child or young adult was really just a battle for survival. But as medical breakthroughs pushed survival rates to historic highs, the biological cost of the cure became more apparent. The chemotherapy and radiation that allowed for survival, often left patients sterile, dashing any future hopes of biological parenthood.
As part of the UCLA Center for Reproductive Science, Health and Education’s distinguished speaker series, Dr. Teresa Woodruff—President of Michigan State University and a National Medal of Science recipient—shared how the field of oncofertility came to be. It’s a field she helped create to enable young cancer survivors to have the eventual option to have their own biological offspring.
From “Heresy” to a New Medical Standard
The field of oncofertility was born from a moment of clinical friction. Woodruff recalled an oncologist’s shock when a mother insisted her 15-year-old son bank his sperm before beginning cancer treatment. At the time, such requests were viewed as a distraction from the life-saving work of oncology.
“Oncologists believed hormones caused cancer, and reproductive specialists believed they only treated the infertile, not the ill,” Woodruff said. “We had to build new corridors of communication.”
Today, those corridors have expanded into a global network. The Oncofertility Consortium now encompasses over 3,000 sites. In the U.S., nearly every pediatric cancer center provides oncofertility care, reducing the average wait time for fertility interventions to just 12 days. This relatively quick response is critical—Woodruff’s research shows that when patients have a plan for their future fertility, their compliance with life-saving cancer drugs increases by 60%.
The “Soap Opera” Effect: A Cultural Shift
To illustrate how far the field has come, Woodruff shared a surprising cultural milestone: a 2010 storyline from the daytime soap opera The Young and the Restless. In the show, a young woman facing cancer surgery decides to flee the hospital because her doctors refused to delay surgery for egg harvesting.
“The ‘cancer patient on the loose’ was a cliffhanger that Friday,” Woodruff joked, but the underlying message was serious. The show captured a real-world tension where patients were forced to choose between their survival and their biological legacy. By the following Monday, the character was seeking a specialist in Chicago—a nod to Woodruff’s then-home at Northwestern University.
3D-Printing the Future: The Bioprosthetic Ovary
While sperm banking is relatively straightforward, the female reproductive system presents a unique biological challenge. Women are born with a finite “reserve” of roughly one million ovarian follicles. For prepubertal girls, these follicles are immature and can’t be harvested as eggs. In addition, transplanting original ovarian tissue back into the body carries the risk of reintroducing dormant cancer cells.
To solve this, Woodruff turned to an unlikely source: the thickener often used in making ice cream. Working with bioengineer Lonnie Shea, Woodruff’s team utilized alginate (a biomaterial derived from seaweed) to create 3D beads. Unlike traditional flat petri dishes, these alginate “beads” allowed follicles to maintain their spherical shape.
“Structure informs function,” Woodruff noted. Within these beads, the follicles organized themselves, developing hormone-producing compartments, and—in a milestone for human biology—they underwent the first-ever successful in vitro ovulation. The eggs matured outside the body, bypassing the risk of reintroducing cancer.
The Zinc Spark and the Periodic Table
Perhaps the most unexpected turn in Woodruff’s research came from her husband, Dr. Thomas O’Halloran, a fellow scientist and biochemist. When he asked why sperm contained so much zinc, Woodruff initially replied with three words she jokingly called the most unfortunate of her life: “I don’t care.”
However, her indifference soon turned to discovery. The pair found that the oocyte (egg) is a “metal-hungry” cell. In the final 12 hours of maturation, an egg accrues 20 billion zinc atoms—an amount Woodruff described as an “absurdity” in cellular biology.
This discovery led to the observation of the “Zinc Spark.” At the moment of activation or fertilization, the egg releases a massive burst of zinc. This “spark” is a fundamental signal that transitions the cell from meiosis to mitosis—effectively turning on the engine of life. The amount of zinc released serves as a non-invasive marker to identify which lab-grown eggs are the most viable for patients.
Q&A: The Environmental Impact on Fertility
During a lively Q&A session with UCLA faculty and students, the conversation turned toward the “middle of the periodic table”—specifically, how environment and nutrition impact human eggs.
• The Iron Anomaly: Woodruff revealed that her team imaged eggs from eight different species, but only the human egg showed an abundance of accumulated iron. She believes this is a consequence of IVF patients over-supplementing with prenatal vitamins. “Patients think if one is good, two is better,” she warned, calling for more rigorous nutritional studies on the ratios of copper, iron, and zinc in prenatal care.
• Heavy Metals: She also noted that in lab settings, high levels of arsenic was found in frog eggs, which traced back to their caging. This serves as a reminder that the environment is linked with our reproductive health in ways we are only beginning to grasp.
A Legacy of “Bedside to Bench to Babies”
As the session closed, Woodruff turned her attention to the UCLA students in the room. She urged them to embrace interdisciplinary collaboration—for example, between a biologist and a chemist, or a doctor and an engineer.
“Always say yes,” she encouraged. “By saying yes to leadership, I was in a position to create a new field of medicine. We need you to take these biological outcomes and ensure they reach the patients who are banking on the research moving at the pace of their future needs.”
Through the work of centers like UCLA’s CRSHE and leaders like Woodruff, cancer treatment is no longer just about survival. It’s also about ensuring that young cancer survivors have the future option of having biological children of their own.
Oncofertility Breakthroughs:
Alginate Beads: Supports follicle growth, allowing follicles to mature in vitro.
Zinc Spark: A newly discovered cell-signaling event that marks egg viability.
3D-Printed Ovary: Restores both fertility and natural hormone production.
Policy Advocacy: Led to 37 states mandating insurance coverage for cancer patients.
Learn More: visit the Reprotopia website or join the 34,000 students enrolled in her Coursera MOOC on Reproductive Science.