Cellular technologies in gynecology and reproductive medicine. (Literature review and own data)

Cellular technologies represent one of the most promising directions in gynecology and reproductive medicine, offering fundamentally novel approaches to the treatment of infertility and other reproductive function disorders. Unlike conventional therapeutic modalities, cell-based therapy targets the pathogenetic mechanisms of disease, promoting restoration of the structural and functional integrity of reproductive organs at the tissue and cellular levels. This article presents an analysis of contemporary cellular technologies employed in gynecology and reproductive medicine, including mesenchymal stem cells of various origins (bone marrow, adipose tissue, umbilical cord, placenta, menstrual blood, and endometrium), extracellular vesicles (exosomes and apoptotic bodies), platelet-rich plasma, microRNA therapy, tissue-engineered scaffolds, bioprinting, and organoid technologies. Particular emphasis is placed on the mechanisms of therapeutic action, encompassing immunomodulation, angiogenesis stimulation, fibrosis suppression, and paracrine secretion of bioactive factors. The results of clinical and experimental studies demonstrating the efficacy of cellular technologies in Asherman’s syndrome, thin endometrium, chronic endometritis, and premature ovarian insufficiency are examined in detail. Evidence indicates that mesenchymal stem cells are capable of restoring ovarian function, stimulating endometrial regeneration, enhancing implantation potential, and increasing pregnancy rates. Contemporary approaches, including bioengineering of extracellular vesicles, utilization of biocompatible scaffolds, and three-dimensional bioprinting, unveil novel opportunities for personalized regenerative therapy. The article also addresses existing limitations and future prospects for the development of cellular technologies, including the necessity for protocol standardization, implementation of large-scale controlled trials, and development of objective predictors of therapeutic response. Cellular technologies constitute a promising strategy for creating innovative, pathogenetically justified treatment methods aimed at restoring reproductive function and improving the efficacy of infertility management.