NMN Protects Fertility During Chemotherapy by Preserving Ovarian Function

Fertility preservation remains a critical challenge for young women undergoing cancer treatment, as chemotherapy drugs like cyclophosphamide can severely damage ovarian function and reduce reproductive capacity by 30-50%. Current fertility preservation methods like egg or embryo freezing are invasive, expensive, and can delay cancer treatment.

This study investigated whether nicotinamide mononucleotide (NMN), a precursor to the cellular energy molecule NAD+, could protect ovarian function during chemotherapy. Researchers treated female mice with cyclophosphamide alone or combined with NMN supplementation over 14 days, then assessed ovarian health and egg quality.

The results were striking. Mice receiving NMN showed significantly better preservation of ovarian reserve, with higher numbers of healthy follicles at all developmental stages. Their eggs demonstrated superior quality with reduced oxidative stress, less DNA damage, and lower rates of cell death. Most importantly, these eggs showed dramatically improved developmental competence - higher rates of successful fertilization and blastocyst formation during in vitro fertilization.

Mechanistically, NMN worked by boosting cellular NAD+ levels in ovarian tissue, which enhanced DNA repair mechanisms and reduced harmful reactive oxygen species. The treatment also influenced key protective genes including Banp and Rbm47 in ovarian tissue, and Sgk1 in eggs themselves.

This research offers hope for a simple, non-invasive fertility preservation approach that could be administered alongside chemotherapy without interfering with cancer treatment timelines. Unlike current methods requiring surgical procedures or treatment delays, NMN supplementation could provide broad accessibility for fertility protection in cancer patients.