Recent Trends in Tissue Engineering Strategies for Uterine Endometrial Regeneration: a Systematic Review.

Endometrial injury is an important cause of infertility and adverse reproductive outcomes, but current treatments often fail to fully restore uterine structure and function. Tissue engineering strategies, including hydrogels, biodegradable scaffolds, 3D bioprinting, organoids, and microfluidic systems, have emerged as promising approaches for endometrial repair. This systematic review evaluated the available evidence on tissue engineering strategies for endometrial regeneration. PubMed, Web of Science, and Scopus were searched for studies published between January 2014 and May 2024. Of 3,381 records identified, 117 studies met the inclusion criteria. Due to substantial heterogeneity in study design and outcome measures, findings were synthesized qualitatively. Hydrogels and biomaterial scaffolds were the most frequently studied approaches, whereas organoids and 3D bioprinting showed potential for disease modeling and personalized regeneration. Microfluidic systems were rarely studied but may have future translational relevance. Tissue engineering approaches appear promising for endometrial repair. However, clinical evidence remains limited, and further human studies are needed to establish safety, efficacy, and long-term durability before routine clinical translation. REGISTRATION NUMBER: CRD420251046577.