Bioengineered uteri help infertile rabbits have normal pregnancies

Researchers say this bioengineering approach could provide a “pathway” to pregnancy for women with an abnormal uterus.

A study published in Nature Biotechnology has seen rabbits have normal pregnancies and live births after their injured uteri were repaired using a method of tissue engineering with their own cells.

The researchers say this approach could have positive implications for women affected by uterine infertility.

Approximately 6% of women undergoing infertility treatment have dysfunction of the uterus.

The fundamental role of the uterus is to allow embryo implantation, fetal nourishment, and growth.

Transplants from live or deceased donors have enabled live births in humans, but a lack of donor organs and the need for immunosuppressive drugs to support the transplanted uterus limit its use.

Bioengineering had already been a success in repairing small uterine defects in rodents, but live birth in larger animals had previously not yet been achieved.

Anthony Atala, principal investigator and director of the Wake Forest Institute for Regenerative Medicine (WFIRM) in the US, said the study showed that engineered uterine tissue is able to support “normal pregnancies”.

“The study shows that engineered uterine tissue is able to support normal pregnancies, and foetal development was normal, with offspring size and weight being comparable to those from a normal uterus,” he said.

“With further development, this approach may provide a pathway to pregnancy for women with an abnormal uterus.”

Scientists implanted biodegradable scaffolds — some with the rabbits’ own uterine cells inserted and some without — into the damaged uteri of 78 rabbits.

They examined the uteri at one, three and six months and found the scaffolds had degraded three months after implantation, and by six months observed no obvious differences between the engineered and native tissues.

Four of the 10 rabbits that received scaffolds seeded with uterine cells had normal pregnancies to term, but none of the 10 rabbits that received unseeded scaffolds did.

Researchers say this approach could provide a “pathway” to pregnancy for women with an abnormal uterus. (Waranya Mooldee, Unsplash)

Co-author Koudy Williams, said: “Our results indicate that the tissue-engineered uteri responded to the expansion and mechanical strains that occur during pregnancy.”

Gudrun Moore, professor of molecular genetics believes the experiment offers “real hope” for the 6% of women with uterine infertility.

“I think this is an excellent study using rabbits as a model, with detailed histochemical and biochemical analysis and all the appropriate controls,” she said.

“I believe this type of experiment offers real hope for the 6% of women with uterine infertility and pushes forward the field in the hope that one day the use of biodegradable polymer scaffolds seeded with autologous cells taken from the uterus of infertile women may help achieve normal pregnancies and births, although we need a lot more research first.”

The researchers are planning more pre-clinical studies before clinical trials are contemplated.

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