Recent Developments in Biomaterial-Based Hydrogel as the Delivery System for Repairing Endometrial Injury

Abstract

Endometrial injury caused by intrauterine surgery often leads to pathophysiological changes in the intrauterine environment, resulting in infertility in women of childbearing age. However, clinical treatment strategies, especially for moderate to severe injuries, often fail to provide satisfactory therapeutic effects and pregnancy outcomes. With the development of reproductive medicine and materials engineering, researchers have developed bioactive hydrogel materials, which can be used as a physical anti-adhesion barrier alone or as functional delivery systems for intrauterine injury treatment by loading stem cells or various active substances. Studies have demonstrated that the biomaterial-based hydrogel delivery system can provide sufficient mechanical support and improve the intrauterine microenvironment, enhance the delivery efficiency of therapeutic agents, prolong intrauterine retention time, and perform efficiently targeted repair compared with ordinary drug therapy or stem cell therapy. It shows the promising application prospects of the hydrogel delivery system in reproductive medicine. Herein, we review the recent advances in endometrial repair methods, focusing on the current application status of biomaterial-based hydrogel delivery systems in intrauterine injury repair, including preparation principles, therapeutic efficacy, repair mechanisms, and current limitations and development perspectives.

Cyclical endometrial repair and regeneration: Molecular mechanisms, diseases, and therapeutic interventions

“…Hydrogel-loaded growth factors can solve the problems of short residence time in vivo and low absorption rate in vivo. [352][353][354] He et al added ε-polylysine (EPL), a functional excipient based on heparin-poloxamer hydrogel, to prepare endometrium-promoting repair hydrogel (EPL-HP hydrogel). In the preparation of hydrogel, the content of EPL was changed to control the hydrogel adhesion.…”

Research progress of stem cell therapy for endometrial injury

“…In order to treat endometrial injury, some researchers have attempted to construct a 3D artificial endometrium rich in endometrial stem cells by simulating the complex physiological and structural properties of the human endometrium [ 141 ]. A variety of biomaterials have been reported to mimic the multicellular and multilayered structure of the human endometrium by incorporating various endometrial cellular components (derived from vascular endothelial cells, stromal cells, and endometrial stem cells) [ 142 ]. Among them, collagen and hyaluronic acid, as the main components of the ECM, have been successfully used in many fields of tissue engineering and regenerative medicine applications due to their relative abundance, inherent biodegradability, and excellent biocompatibility [ 139 , [143] , [144] , [145] ].…”

Bioactive Injectable and Self‐Healing Hydrogel Via Cell‐Free Fat Extract for Endometrial Regeneration

“…Among many biomaterials, [21][22][23] injectable hydrogels have good uterine perfusion applicability. It is a kind of fiber network system with 3D structure, which is formed by crosslinking water-soluble or hydrophilic polymers through chemical covalent bonds or physical interactions.…”