Bioengineering of the Uterus

Abstract

Impairment of uterine structure and function causes infertility, pregnancy loss, and perinatal complications in humans. Some types of uterine impairments such as Asherman’s syndrome, also known as uterine synechiae, can be treated medically and surgically in a standard clinical setting, but absolute defects of uterine function or structure cannot be cured by conventional approaches. To overcome such hurdles, partial or whole regeneration and reconstruction of the uterus have recently emerged as new therapeutic strategies. Transplantation of the whole uterus into patients with uterine agenesis results in the successful birth of children. However, it remains an experimental treatment with numerous difficulties such as the need for continuous and long-term use of immunosuppressive drugs until a live birth is achieved. Thus, the generation of the uterus by tissue engineering technologies has become an alternative but indispensable therapeutic strategy to treat patients without a functional or well-structured uterus. For the past 20 years, the bioengineering of the uterus has been studied intensively in animal models, providing the basis for clinical applications. A variety of templates and scaffolds made from natural biomaterials, synthetic materials, or decellularized matrices have been characterized to efficiently generate the uterus in a manner similar to the bioengineering of other organs and tissues. The goal of this review is to provide a comprehensive overview and perspectives of uterine bioengineering focusing on the type, preparation, and characteristics of the currently available scaffolds.

Evaluation of IL-1β and TNF-α level in endometrial flush in patients with recurrent implantation failure

“…Current data plead to demonstrate that the endometrium is not a passive partner in the reproductive process, as it was initially regarded. Functionally, the endometrium is defined as a highly dynamic tissue encompassing a functional layer, which results in the implantation site of the embryo and is completely shed during menstruation, and a basal layer, which is crucial for the optimal reconstruction of the epithelium after the menstrual cycle [9][10][11].…”

Advances in the clinical application of ultrasound elastography in uterine imaging

“…During the menstrual cycle, major structural changes occur in the endometrium. When desquamated, the upper, functional layer of the endometrium is completely sloughed off, followed by reconstruction during the proliferative phase and then the secretory phase [ 56 ]. Soliman et al showed that menopausal status did not significantly affect the Cs measurements by ARFI [ 57 ].…”

Characterization of Marine Organism Extracellular Matrix-Anchored Extracellular Vesicles and Their Biological Effect on the Alleviation of Pro-Inflammatory Cytokines

“…The composition of the ECM and the types of cells present in each tissue are also different. For example, factors involved in anti-angiogenesis and adhesion, which are rare in the cartilage-derived ECM [41], exist in other tissues, whereas factors involved in angiogenesis and adhesion are abundant in the uterine ECM [42,43]. As in the examples, there are differences in components and biological effects, because cells in each source tissue release ECMs to the outside to fit the environment [44].…”