Decellularized ovarian scaffolds as biomimetic platforms for follicular development, ovarian cell function, and stem cell-matrix interactions: A systematic review.

Infertility affects a substantial proportion of the global population and remains a significant clinical challenge, particularly in patients with compromised ovarian function. Decellularized ovarian tissue is currently being investigated as a promising platform for providing a biomimetic microenvironment that supports follicular development and advances artificial ovary technologies. This systematic review critically evaluates the effectiveness of decellularized ovarian scaffolds in supporting ovarian cell, follicular, and stem cell development. Following PRISMA guidelines, we conducted a comprehensive literature search including in vitro and in vivo studies employing decellularized ovarian tissue as a bioscaffold. The findings indicate that these scaffolds support key biological processes, such as cellular adhesion, migration, differentiation, and survival. In addition, the formation of follicle-like structures and the expression of granulosa-, theca-, oocyte-, and stem cell-associated markers were reported. In vivo studies further demonstrated the restoration of hormonal function and the development of organized follicular architecture. Overall, decellularized ovarian scaffolds represent a biologically active platform with the potential to partially recapitulate the native ovarian microenvironment and guide follicular organization, ovarian cell function, and stem cell responses.