{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T05:34:37Z","timestamp":1763098477473,"version":"3.45.0"},"reference-count":47,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Polymers"],"abstract":"<jats:p>Three-dimensional printing has been progressively integrated into various industries, particularly the medical sector, where its significance in tissue engineering for transplantation is growing exponentially. The purpose of this systematic review is to ascertain whether the bioprinting of scaffolds holds the potential to provide treatment for pathologies within the female reproductive system. The inclusion criteria applied were the bioimprinting of the ovary, uterus, endometrium, or vagina, intended for surgical implantation in the patient. Articles employing printing methods that do not incorporate cells embedded in the material, those that generate tissue other than that of the female reproductive system, and those that print structures with in vitro applications were excluded from the review. The search for relevant articles was conducted until 3 April 2025. After analyzing 667 articles extracted from PubMed, Scopus and Web of Science, 13 articles were included in this review. The analysis of the results encompassed aspects related to the bioprinting technology employed, the hydrogels and cells utilized, as well as the bioprinted structure and the corresponding target tissue. Few studies investigated the creation of a multicellular scaffold and in none of the cases was it implanted in a large animal model, only in murine and rabbit models. These articles reaffirm the feasibility of employing 3D bioprinting to fabricate tissues and functional organs in the present and future. This advancement will revolutionize the future demand for organs for transplantation.<\/jats:p>","DOI":"10.3390\/polym17223010","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T09:59:09Z","timestamp":1763027949000},"page":"3010","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Therapeutic Applications of 3D Bioprinting in Surgery for Female Reproductive Tract Disorders: A Systematic Review"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5070-8429","authenticated-orcid":false,"given":"Joaqu\u00edn","family":"G\u00f3mez-Abell\u00e1n","sequence":"first","affiliation":[{"name":"Bioengineering and Health Technologies Unit, Jes\u00fas Us\u00f3n Minimally Invasive Surgery Centre, 10071 C\u00e1ceres, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0688-9626","authenticated-orcid":false,"given":"Raquel","family":"L\u00f3pez-Flores","sequence":"additional","affiliation":[{"name":"Assisted Reproduction Unit, Jes\u00fas Us\u00f3n Minimally Invasive Surgery Centre, 10071 C\u00e1ceres, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0100-2695","authenticated-orcid":false,"given":"Juan A.","family":"S\u00e1nchez-Margallo","sequence":"additional","affiliation":[{"name":"Bioengineering and Health Technologies Unit, Jes\u00fas Us\u00f3n Minimally Invasive Surgery Centre, 10071 C\u00e1ceres, Spain"},{"name":"Red RICORS-TERAV, ISCIII, 28222 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7545-1485","authenticated-orcid":false,"given":"Soledad","family":"S\u00e1nchez-Mateos","sequence":"additional","affiliation":[{"name":"Assisted Reproduction Unit, Jes\u00fas Us\u00f3n Minimally Invasive Surgery Centre, 10071 C\u00e1ceres, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2138-988X","authenticated-orcid":false,"given":"Francisco M.","family":"S\u00e1nchez-Margallo","sequence":"additional","affiliation":[{"name":"Red RICORS-TERAV, ISCIII, 28222 Madrid, Spain"},{"name":"Scientific Direction, Jes\u00fas Us\u00f3n Minimally Invasive Surgery Centre, 10071 C\u00e1ceres, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Ka\u010darevi\u0107, \u017d.P., Rider, P.M., Alkildani, S., Retnasingh, S., Smeets, R., Jung, O., Ivani\u0161evi\u0107, Z., and Barbeck, M. (2018). An Introduction to 3D Bioprinting: Possibilities, Challenges and Future Aspects. Materials, 11.","DOI":"10.3390\/ma11112199"},{"key":"ref_2","unstructured":"Crump, S.S. (1989). Apparatus and Method for Creating Three-Dimensional Objects. (5121329A), U.S. Patent."},{"key":"ref_3","unstructured":"Swanson, W.J., Turley, P.W., Leavitt, P.J., Karwoski, P.J., LaBossiere, J.E., and Skubic, R.L. (2004). High temperature modeling apparatus. (US6722872B1), U.S. Patent."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Crooki, J.M. (2020). History and Trends of 3D Bioprinting. 3D Bioprinting: Principles and Protocols, Springer.","DOI":"10.1007\/978-1-0716-0520-2"},{"key":"ref_5","unstructured":"Hull, C.W. (1986). Apparatus for Production of Three-Dimensional Objects by Stereolithography. (4575330A), U.S. Patent."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/S0167-7799(99)01355-4","article-title":"Laser-guided direct writing for applications in biotechnology","volume":"17","author":"Odde","year":"1999","journal-title":"Trends Biotechnol."},{"key":"ref_7","unstructured":"Deckard, C.R. (1997). Apparatus for Producing Parts by Selective Sintering. (US5597589A), U.S. Patent."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1016\/S0140-6736(06)68438-9","article-title":"Tissue-engineered autologous bladders for patients needing cystoplasty","volume":"367","author":"Atala","year":"2006","journal-title":"Lancet"},{"key":"ref_9","unstructured":"Wake Forest Institute for Regenerative Medicine (2025, October 17). A Record of Firsts. Available online: https:\/\/school.wakehealth.edu\/research\/institutes-and-centers\/wake-forest-institute-for-regenerative-medicine\/research\/a-record-of-firsts."},{"key":"ref_10","first-page":"529","article-title":"Development of 3D bioprinting: From printing methods to biomedical applications","volume":"15","author":"Gu","year":"2020","journal-title":"Asian J. Pharm. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"4437","DOI":"10.1016\/S0142-9612(02)00139-4","article-title":"Rapid prototyping of scaffolds derived from thermoreversible hydrogels and tailored for applications in tissue engineering","volume":"23","author":"Landers","year":"2002","journal-title":"Biomaterials"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.ciresp.2016.12.008","article-title":"Clinical xenotransplantation, a closer reality: Literature review","volume":"95","author":"Aristizabal","year":"2017","journal-title":"Cir. Esp."},{"key":"ref_13","unstructured":"National Cancer Institute (2025, October 17). Definition of Implant. NCI Dictionary of Cancer Terms, Available online: https:\/\/www.cancer.gov\/publications\/dictionaries\/cancer-terms\/def\/implant."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Haynes, J.S. (2023). Pathology of the female reproductive system. Atlas of Veterinary Surgical Pathology, John Wiley & Sons, Ltd.","DOI":"10.1002\/9781119261254.ch3"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1016\/S0015-0282(16)57797-8","article-title":"Effect of aging on the female reproductive system: Evidence for a role of uterine senescence in the decline in female fecundity","volume":"64","author":"Cano","year":"1995","journal-title":"Fertil. Steril."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1093\/humupd\/dmac025","article-title":"Bioengineering trends in female reproduction: A systematic review","volume":"28","author":"Lopez","year":"2022","journal-title":"Hum. Reprod. Updat."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Souza, G.R., Tseng, H., Gage, J.A., Mani, A., Desai, P., Leonard, F., Liao, A., Longo, M., Refuerzo, J.S., and Godin, B. (2017). Magnetically Bioprinted Human Myometrial 3D Cell Rings as A Model for Uterine Contractility. Int. J. Mol. Sci., 18.","DOI":"10.3390\/ijms18040683"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.actbio.2020.09.012","article-title":"3D Bioprinting a human iPSC-derived MSC-loaded scaffold for repair of the uterine endometrium","volume":"116","author":"Ji","year":"2020","journal-title":"Acta Biomater."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1002\/term.57","article-title":"Two-photon polymerization technique for microfabrication of CAD-designed 3D scaffolds from commercially available photosensitive materials","volume":"1","author":"Ovsianikov","year":"2007","journal-title":"J. Tissue Eng. Regen. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"15261","DOI":"10.1038\/ncomms15261","article-title":"A bioprosthetic ovary created using 3D printed microporous scaffolds restores ovarian function in sterilized mice","volume":"8","author":"Laronda","year":"2017","journal-title":"Nat. Commun."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1080\/13697137.2021.1921726","article-title":"Three-dimensional bioprinting of artificial ovaries by an extrusion-based method using gelatin-methacryloyl bioink","volume":"25","author":"Wu","year":"2022","journal-title":"Climacteric"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Aci\u00e9n, P., Nohales-Alfonso, F.J., S\u00e1nchez-Ferrer, M.L., S\u00e1nchez-Lozano, M., Navarro-Lillo, V., and Aci\u00e9n, M. (2019). Clinical pilot study to evaluate the neovaginal PACIENA prosthesis\u00ae for vaginoplasty without skin grafts in women with vaginal agenesis. BMC Women\u2019s Health, 19.","DOI":"10.1186\/s12905-019-0841-z"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.ijbiomac.2021.03.070","article-title":"Printing 3D vagina tissue analogues with vagina decellularized extracellular matrix bioink","volume":"180","author":"Hou","year":"2021","journal-title":"Int. J. Biol. Macromol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"120290","DOI":"10.1016\/j.ijpharm.2021.120290","article-title":"3D printed clotrimazole intravaginal ring for the treatment of recurrent vaginal candidiasis","volume":"596","author":"Tiboni","year":"2021","journal-title":"Int. J. Pharm."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Zhao, C., Wang, Z., Hua, C., Ji, J., Zhou, Z., Fang, Y., Weng, D., Lu, L., Pang, Y., and Sun, W. (2020). Design, modeling and 3D printing of a personalized cervix tissue implant with protein release function. Biomed. Mater., 15.","DOI":"10.1088\/1748-605X\/ab7b3b"},{"key":"ref_26","unstructured":"Royo, M. (2025, October 17). BiblioGu\u00edas: Revisiones Sistem\u00e1ticas: Definici\u00f3n: \u00bfQu\u00e9 es Una Revisi\u00f3n Sistem\u00e1tica? Universidad de La Rioja: Logrono, Spain. Available online: https:\/\/biblioguias.unav.edu\/revisionessistematicas\/que-es-una-revision-sistematica."},{"key":"ref_27","unstructured":"Cochrane Library (2025, October 17). Cochrane: London, UK. Available online: https:\/\/www.cochranelibrary.com\/es\/."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"431","DOI":"10.6018\/eglobal.15.3.239221","article-title":"El dise\u00f1o de preguntas cl\u00ednicas en la pr\u00e1ctica basada en la evidencia. Modelos de formulaci\u00f3n","volume":"15","author":"Ronda","year":"2016","journal-title":"Enfermer\u00eda Glob."},{"key":"ref_30","first-page":"12","article-title":"C\u00f3mo Aprender (y Ense\u00f1ar) a Realizar B\u00fasquedas en CINAHL y PubMed","volume":"14","year":"2017","journal-title":"Evidencia"},{"key":"ref_31","unstructured":"(2025, October 17). Perform Systematic Literature Reviews, Available online: https:\/\/www.cdc.gov\/library\/research-guides\/systematic-reviews.html."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Hooijmans, C.R., Rovers, M.M., de Vries, R.B.M., Leenaars, M., Ritskes-Hoitinga, M., and Langendam, M.W. (2014). SYRCLE\u2019s risk of bias tool for animal studies. BMC Med. Res. Methodol., 14.","DOI":"10.1186\/1471-2288-14-43"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1186\/s13287-022-03035-3","article-title":"Drug-free in vitro activation combined with 3D-bioprinted adipose-derived stem cells restores ovarian function of rats with premature ovarian insufficiency","volume":"13","author":"Li","year":"2022","journal-title":"Stem Cell Res. Ther."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Zheng, J., Liu, Y., Hou, C., Li, Z., Yang, S., Liang, X., Zhou, L., Guo, J., Zhang, J., and Huang, X. (2022). Ovary-derived Decellularized Extracellular Matrix-based Bioink for Fabricating 3D Primary Ovarian Cells-laden Structures for Mouse Ovarian Failure Correction. Int. J. Bioprint., 8.","DOI":"10.18063\/ijb.v8i3.597"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.actbio.2025.03.009","article-title":"Developing and characterising bovine decellularized extracellular matrix hydrogels to biofabricate female reproductive tissues","volume":"196","author":"Martinez","year":"2025","journal-title":"Acta Biomater."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"20230141","DOI":"10.1002\/EXP.20230141","article-title":"Biomimicking trilayer scaffolds with controlled estradiol release for uterine tissue regeneration","volume":"4","author":"Chen","year":"2024","journal-title":"Exploration"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"23067","DOI":"10.1021\/acsomega.1c02117","article-title":"Bioprinting of a blue light-cross-linked biodegradable hydrogel encapsulating amniotic mesenchymal stem cells for intrauterine adhesion prevention","volume":"6","author":"Feng","year":"2021","journal-title":"ACS Omega"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"6772","DOI":"10.1021\/acsami.3c14983","article-title":"Multilayered shape-morphing scaffolds with a hierarchical structure for uterine tissue regeneration","volume":"16","author":"Chen","year":"2024","journal-title":"ACS Appl. Mater. Interfaces"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.actbio.2022.12.016","article-title":"3D bio-printed endometrial construct restores the full-thickness morphology and fertility of injured uterine endometrium","volume":"157","author":"Nie","year":"2023","journal-title":"Acta Biomater."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.actbio.2019.08.003","article-title":"3D bioprinted endometrial stem cells on melt electrospun poly \u03b5-caprolactone mesh for pelvic floor application promote anti-inflammatory responses in mice","volume":"97","author":"Paul","year":"2019","journal-title":"Acta Biomater."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Hong, J., Ahn, H., Moon, S.Y., Kang, H.J., and Yi, K.W. (2023). Effect of collagen endometrial patch loaded with adipose-derived mesenchymal stem cells on endometrial regeneration in rats with a thin endometrium. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1287789"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Zheng, J., Zhang, X., Guo, K., Yan, L., Xu, X., Shi, W., Zhang, J., Du, Y., Zhang, M., and Huang, X. (2024). Enhancing vaginal reconstruction through 3D bioprinted scaffolds using a novel vECM-GelMA-SF bioink. Biofabrication, 17.","DOI":"10.1088\/1758-5090\/ad95bf"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Dzobo, K., and Dandara, C. (2023). The extracellular matrix: Its composition, function, remodeling, and role in tumorigenesis. Biomimetics, 8.","DOI":"10.20944\/preprints202301.0555.v1"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Arif, Z.U., Khalid, M.Y., Ahmed, W., and Arshad, H. (2022). A review on four-dimensional (4D) bioprinting in pursuit of advanced tissue engineering applications. Bioprinting, 27.","DOI":"10.1016\/j.bprint.2022.e00203"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Teng, Y., Song, L., Shi, J., Lv, Q., Hou, S., and Ramakrishna, S. (2025). Advancing electrospinning towards the future of biomaterials in biomedical engineering. Regen. Biomater., 12.","DOI":"10.1093\/rb\/rbaf034"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1177\/2472630319857966","article-title":"FFabrication of bioengineered skin by injection molding: A feasibility study on automation","volume":"24","author":"Fox","year":"2019","journal-title":"SLAS Technol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.actbio.2024.08.007","article-title":"Electrically conductive coatings in tissue engineering","volume":"186","author":"Kohestani","year":"2024","journal-title":"Acta Biomater."}],"container-title":["Polymers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2073-4360\/17\/22\/3010\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T05:33:40Z","timestamp":1763098420000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2073-4360\/17\/22\/3010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,12]]},"references-count":47,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["polym17223010"],"URL":"https:\/\/doi.org\/10.3390\/polym17223010","relation":{},"ISSN":["2073-4360"],"issn-type":[{"type":"electronic","value":"2073-4360"}],"subject":[],"published":{"date-parts":[[2025,11,12]]}}}