Abstract
Advances in cancer therapy, delayed parenthood, and an increasing number of reproductive disorders have intensified the need for the effective preservation of fertility. However, current clinical strategies such as ovarian tissue cryopreservation, transplantation, and hormonal stimulation remain limited in scope and efficacy. Biomaterials have emerged as powerful tools to overcome these limitations, enabling fertility preservation and functional restoration of reproductive and endocrine systems. Recent progress has included the development of hydrogel-based systems for in vitro follicle maturation, bioengineered scaffolds for ovarian tissue support, and artificial ovaries capable of hormone secretion and oocyte development. These platforms are increasingly incorporating immunomodulatory features to address rejection and enhance graft integration. Beyond preservation, biomaterials are also being harnessed to repair reproductive damage caused by conditions such as primary ovarian insufficiency, intrauterine adhesions, and endometriosis. Through tunable biochemical and mechanical properties, materials can direct tissue regeneration, modulate inflammation, and restore physiological functions. Emerging technologies, including biofabrication with reproductive-specific bioinks, organoid models, hormone-responsive systems, and artificial intelligence-driven biomaterial designs, are accelerating innovation toward translational applications. Collectively, these developments represent a paradigm shift in reproductive medicine from passive preservation to active regenerative strategies. This review highlights the state-of-the-art biomaterial-enabled fertility restoration and outlines future directions toward personalized, functional, and clinically viable solutions.