Acta Mechanica Slovaca 2025, 29(3):16-22 | DOI: 10.21496/ams.2025.026

Uterine Factor Infertility: Current Therapeutic Frontiers and the Promise of Uterine Bioengineering

Zuzana Trebuňová1, *, Erik Dosedla2, Jozef Živčák1, Peter Frankovský3
1 Technical University of Košice, Faculty of Mechanical Engineering, Department of Biomedical Engineering and Measurement, Letná 1/9, 04200, Košice-Sever, Slovakia
2 Faculty Hospital AGEL Košice-Šaca, Lúčná 57, 040 15 Košice-Šaca, Slovakia
3 Technical University of Košice, Faculty of Mechanical Engineering, Department of Applied Mechanics and Mechanical Engineering, Letná 1/9, 04200, Košice-Sever, Slovakia

Absolute uterine factor infertility (AUFI), resulting from congenital absence or non-functionality of the uterus, affects approximately 1 in 500 women of reproductive age and remains one of the most challenging forms of female infertility. While uterine transplantation has enabled successful pregnancies, it is associated with substantial limitations including donor scarcity, long-term immunosuppression, and ethical concerns. As a promising alternative, uterine tissue engineering aims to restore reproductive function using biocompatible scaffolds, often combined with stem or progenitor cells. This review summarizes current experimental and clinical evidence on scaffold-based and stem cell-driven approaches to uterine regeneration. Various cell sources have been explored, including mesenchymal stem cells (MSCs), embryonic stem cells (ESCs), and induced pluripotent stem cells (iPSCs), with MSCs emerging as the most clinically feasible due to their immunomodulatory properties and accessibility. Scaffold types range from natural biomaterials (e.g., collagen) to synthetic polymers and decellularized extracellular matrices. Recent preclinical and clinical studies demonstrate promising outcomes in regenerating endometrial tissue and restoring fertility in conditions such as Asherman's syndrome. Nonetheless, challenges remain in standardization, long-term safety, and translation to widespread clinical use. Continued multidisciplinary research and advances in 3D bioprinting and personalized regenerative strategies may soon redefine the therapeutic landscape for AUFI.

Keywords: uterine factor infertility, uterine tissue engineering, uterine regeneration, stem cells, scaffold, uterine bioengineering, endometrial repair, 3D bioprinting.

Received: June 6, 2025; Revised: October 8, 2025; Accepted: October 29, 2025; Published: October 1, 2025  Show citation

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Trebuňová, Z., Dosedla, E., Živčák, J., & Frankovský, P. (2025). Uterine Factor Infertility: Current Therapeutic Frontiers and the Promise of Uterine Bioengineering. Acta Mechanica Slovaca, 29(3), 16-22. doi: 10.21496/ams.2025.026
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