Background: To provide the optimal milieu for implantation and fetal development, the female reproductive system must orchestrate uterine dynamics with the appropriate hormones produced by the ovaries. Mature oocytes may be fertilized in the fallopian tubes, and the resulting zygote is transported toward the uterus, where it can implant and continue developing. The cervix acts as a physical barrier to protect the fetus throughout pregnancy, and the vagina acts as a birth canal (involving uterine and cervix mechanisms) and facilitates copulation. Fertility can be compromised by pathologies that affect any of these organs or processes, and therefore, being able to accurately model them or restore their function is of paramount importance in applied and translational research. However, innate differences in human and animal model reproductive tracts, and the static nature of 2D cell/tissue culture techniques, necessitate continued research and development of dynamic and more complex in vitro platforms, ex vivo approaches and in vivo therapies to study and support reproductive biology. To meet this need, bioengineering is propelling the research on female reproduction into a new dimension through a wide range of potential applications and preclinical models, and the burgeoning number and variety of studies makes for a rapidly changing state of the field.
Objective And Rationale: This review aims to summarize the mounting evidence on bioengineering strategies, platforms and therapies currently available and under development in the context of female reproductive medicine, in order to further understand female reproductive biology and provide new options for fertility restoration. Specifically, techniques used in, or for, the uterus (endometrium and myometrium), ovary, fallopian tubes, cervix and vagina will be discussed.
Search Methods: A systematic search of full-text articles available in PubMed and Embase databases was conducted to identify relevant studies published between January 2000 and September 2021. The search terms included: bioengineering, reproduction, artificial, biomaterial, microfluidic, bioprinting, organoid, hydrogel, scaffold, uterus, endometrium, ovary, fallopian tubes, oviduct, cervix, vagina, endometriosis, adenomyosis, uterine fibroids, chlamydia, Asherman's syndrome, intrauterine adhesions, uterine polyps, polycystic ovary syndrome and primary ovarian insufficiency. Additional studies were identified by manually searching the references of the selected articles and of complementary reviews. Eligibility criteria included original, rigorous and accessible peer-reviewed work, published in English, on female reproductive bioengineering techniques in preclinical (in vitro/in vivo/ex vivo) and/or clinical testing phases.
Outcomes: Out of the 10 390 records identified, 312 studies were included for systematic review. Owing to inconsistencies in the study measurements and designs, the findings were assessed qualitatively rather than by meta-analysis. Hydrogels and scaffolds were commonly applied in various bioengineering-related studies of the female reproductive tract. Emerging technologies, such as organoids and bioprinting, offered personalized diagnoses and alternative treatment options, respectively. Promising microfluidic systems combining various bioengineering approaches have also shown translational value.
Wider Implications: The complexity of the molecular, endocrine and tissue-level interactions regulating female reproduction present challenges for bioengineering approaches to replace female reproductive organs. However, interdisciplinary work is providing valuable insight into the physicochemical properties necessary for reproductive biological processes to occur. Defining the landscape of reproductive bioengineering technologies currently available and under development for women can provide alternative models for toxicology/drug testing, ex vivo fertility options, clinical therapies and a basis for future organ regeneration studies.
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http://dx.doi.org/10.1093/humupd/dmac025 | DOI Listing |
Biol Reprod
January 2025
Department of Integrative Physiology, Baylor College of Medicine, Houston, TX USA.
The physiological and clinical importance of motile cilia in reproduction is well recognized, however, the specific role they play in transport through the oviduct and how ciliopathies lead to subfertility and infertility is still unclear. The contribution of cilia beating, fluid flow, and smooth muscle contraction to overall progressive transport within the oviduct remains under debate. Therefore, we investigated the role of cilia in the oviduct transport of preimplantation eggs and embryos using a combination of genetic and advanced imaging approaches.
View Article and Find Full Text PDFImportance: This article highlights key National Institutes of Health (NIH) programs, policies, and scientific advances that have informed and improved the health of women and describe the promise and potential of harnessing cutting-edge science and integrative approaches to advance women's health research. Policy updates combined with recent scientific and programmatic initiatives are intended to expand understanding of women's health, deliver diagnostics, and develop preventive approaches and novel therapies to meet critical health needs of contemporary women.
Observations: To benefit all people through the work funded and conducted by the NIH biomedical research enterprise, NIH has implemented policies that broadly expanded the knowledge of human health and disease from the laboratory to the clinic.
Andes Pediatr
October 2024
Facultad de Medicina Occidente, Universidad de Chile, Santiago, Chile.
Polycystic Ovary Syndrome (PCOS) is the most common endocrine-metabolic disorder in female adolescents, and it is associated with metabolic, cardiovascular, and reproductive complications. Recent findings also suggest an association with psychiatric pathology, both affected patients and their offspring. In this update, we synthesized the recent literature on mental health in women and adolescents with PCOS through a systematic search in PubMed, Epistemonikos, and Scielo for articles published in the last 5 years.
View Article and Find Full Text PDFHeliyon
December 2024
Pharmacology, Toxicology and Clinical Pharmacology, Department of Morphofunctional Sciences, "Iuliu Haţieganu" University of Medicine and Pharmacy, Victor Babeș, No 8, 400012, Cluj-Napoca, Romania.
This study aimed to assess the influence of different types of blue light sources on male and female rats' puberty onset, the morphologic-induced alterations in reproductive organs tissues, the impact on inflammation and oxidative stress markers, anxiety levels, and mathematical modeling for tissue data interpretation. Four groups of sixteen rats each (8 females and 8 males/group) were investigated: three groups were exposed to blue light from mobile phones (MP), computer screens (PC), or LED lamps (LED) versus the control group (CTRL). The rats in the CTRL group had no exposure while the other groups were exposed for 30 days to the blue light of MP, PC, and LED for 16 h per day.
View Article and Find Full Text PDFCureus
January 2025
Department of Surgery, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, GBR.
Background Ectopic pregnancy (EP) is a significant cause of maternal morbidity and mortality. Accurate and timely diagnosis is crucial, particularly in women of reproductive age presenting with acute abdominal pain. This audit aimed to assess the completeness and accuracy of gynecological history documentation, including pregnancy status, in female patients admitted for emergency surgery due to abdominal pain.
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