Bioengineered Scaffolds and Stem Cells Offer New Hope for Uterine Regeneration

Uterine disorders — particularly thin endometrium and intrauterine adhesions — affect millions of women worldwide and represent a persistent barrier to successful pregnancy. Conventional treatments often fail to fully restore endometrial function, leaving a significant unmet clinical need. This review examines the rapidly evolving landscape of regenerative and bioengineering strategies designed to address that gap.

The authors from CHA University systematically survey biomaterial-based approaches to endometrial repair. Biomaterials serve multiple roles: as structural scaffolds, as delivery vehicles for therapeutic cells and molecules, and as active modulators of the tissue microenvironment. Mesenchymal stem cells sourced from reproductive and other tissues, along with their extracellular vesicles, have shown promise in promoting new blood vessel formation, reducing fibrosis, and calibrating immune responses to support healing.

Beyond cell-based therapies, platelet-rich plasma and pharmacological agents delivered via nanocarriers offer additional regenerative potential. Engineered scaffolds — particularly those derived from decellularized extracellular matrix or fabricated through three-dimensional bioprinting — are highlighted as especially promising because they replicate the biomechanical and biochemical properties of native endometrium. These constructs support cellular engraftment and serve as in vitro models for studying endometrial physiology.

A pivotal development noted in the review is the creation of uterus-derived extracellular matrix scaffolds combined with organoid technology. These systems reduce immune rejection risk and improve clinical translatability, moving the field closer to personalized, tissue-specific therapies.

Despite significant progress, challenges remain. Standardizing biomaterial fabrication, ensuring long-term scaffold integration, and navigating regulatory pathways for cell-based therapies are ongoing hurdles. The review underscores that translating these innovations from bench to bedside will require coordinated advances in immunology, materials science, and reproductive medicine.