Research indicates bioengineered uterine tissue can support normal pregnancy

Reviewed by Emily Henderson, B.Sc.June 29, 2020

In a new study at the Wake Forest Institute of Regenerative Medicine (WFIRM), scientists show that bioengineered wombs support fertilization, fetal development, and birth of normal offspring. With further development, this approach may someday provide regenerative medicine solutions to women who cannot conceive due to infertility of uterine dysfunction

Scientists, published today in Nature Biotechnology, may show that the animal model’s bioengineered uterus has developed the native tissue-like structure necessary to support normal reproductive function. I’m done.

In this study, artificial uterine tissue was able to support normal pregnancy, fetal development was normal, and offspring size and weight were comparable to those of a normal uterus. With further development, this approach may provide a path to pregnancy in women with abnormal uterus. “

Anthony Atala, MD, Principal Investigator and WFIRM Director

WFIRM scientists are the world leaders in the field of regenerative medicine, and many of the fundamental principles of tissue engineering and regenerative medicine were first developed in the laboratory. Their strategy of bioengineering functional tissue using patient’s own cells seeded on biodegradable scaffolds has been effectively explored in preclinical studies and restores function in tubular and hollow non-tubular organs Has been successfully applied to human patients because. Regenerative medicine and tissue engineering techniques are emerging as attractive options to overcome the shortage and other limitations of organ transplantation from donors. Using the same bioengineering strategy, scientists designed the uterus, a more complex organ with higher functional requirements including embryo implantation and fetal development support.

In this study, rabbits were randomly assigned to four groups. (1) A tissue-engineered uterus group that received cell-seeded scaffolds using the animals’ own cells. (2) Non-seeded scaffolding group that received only polymer scaffolding. (3) Hysterectomy only control group in which partial resection was repaired by suture, and (4) Normal control group in which animals underwent sham laparotomy.

Rabbits have long been used in reproductive biology studies and have a relatively large uterus compared to other laboratory animals, making them ideal for uterine tissue regeneration studies. The female rabbit uterus consists of two separate functional horns and a uterus, each of which is capable of pregnancy.

Biodegradable polymer scaffolding structures were custom made for each animal. Uterine tissue was regenerated and the cells required to seed the scaffold were cultured and grown from the uterine structure of each rabbit. Six months after undergoing the scaffolding procedure, the rabbit spontaneously mated with a fertile male rabbit.

“Rabbits with a cell-seeded structure had a normal pregnancy in the reconstructed part of the uterus,” said co-author Dr. Renata S. Magallas, BCMAS. “This study presents a new avenue for potentially creating tissue substitutes derived from patients’ own cells to treat uterine defects.”

Uterine transplantation from a dead living donor into a patient has shown promise as a treatment for permanent uterine infertility, although it requires the use of antirejection therapy.

To date, about 70 uterine transplants have been performed worldwide. In the United States, fewer than 10 babies are born through a transplanted uterus. This proposed strategy creates uterine tissue using the patient’s own cells, avoiding death or the need for transplanted organs from living donors, avoiding the risk of rejection and the need for anti-rejection drugs ..

“Our results show that the tissue-engineered uterus responded to the expansion and mechanical strain that occurs during pregnancy,” said co-author Coody Williams, DVM. “Before the clinical trials are considered, more preclinical trials are planned.”