Introduction
Fertility is a key element in society and individual health. The World Health Organization (WHO) has considered infertility as a global public health problem, which is seen in 8-12% of couples at reproductive age. Female infertility may be due to problems in menstrual cycles and ovulation, structural abnormalities of the reproductive system, infection, implantation failures, uterine fibroids, polycystic ovaries, endometriosis, and immunological disorders. It has been reported that vaginal aplasia, the congenital absence of a normal vagina, can be caused by various disorders, including Müllerian duct anomalies, abnormal endocrine gland function, adrenal hyperplasia, and other gender abnormalities. Acquired disorders such as cancer and trauma may also cause damage to the vagina [3]. Currently, there are few treatment options for women who are faced with the problems of chemotherapy threatening follicles [4]. Recently, tissue engineering using biological materials, stem cells and molecular factors has been proposed as an alternative method for the reconstruction of female reproductive tissues. Studies have showed that reproductive medicine has made significant progress in the past decades due to the development of assisted reproductive technologies (ARTs), which have greatly helped women with infertility [7]. This study aims to review the biological materials and strategies employed in the tissue engineering of female reproductive organs and tissues.

Methods
In this study, articles were searched using the keywords “infertility”, “tissue engineering”, “female reproductive organs”, “vagina”, “uterus”, “ovary” and “follicle” by two authors in Web of Science, PubMed, Scopus, Science Direct and Google Scholar databases. After excluding case reports, letters to the editor, abstract articles and articles with unclear methodology and analysis, finally 82 articles were selected and reviewed.

Results

Ovarian tissue engineering 
To restore ovarian function, various hormonal treatments or ARTs, including ovarian tissue freezing, autograft and xenograft, laboratory maturation, oocyte fertilization, and the creation of potential artificial ovaries have been reported in recent studies [7, 8]. To create a so-called artificial ovary using biomaterials, it is necessary to evaluate in vitro and in vivo conditions. The used biomaterials should have the ability to support the growth of follicles and ovarian stromal cells and the ability to be connected in a 3-dimensional structure. Natural biomaterials have properties similar to the extracellular matrix of human tissues and have intrinsic bioactivity, while synthetic polymers have poor biocompatibility and lose their mechanical properties and produce toxic products during degradation.. However, synthetic polymers can be used as hydrogel scaffolds [5, 9]. Collagen-based biomaterials such as collagen hydrogels, decellularized extracellular matrix, and bioengineering techniques, including collagen-based 3D printing, have facilitated the reproductive tissue engineering [10]. In one study, somatic cells and ovarian follicles were cultured on 3D gelatin scaffolds. The results showed an increase in the adhesion of follicles and an increase in the survival of eggs [16]. 
Silicon is one of the most abundant chemical elements on earth, and due to its unique chemical and physical properties, materials based on silicon and its oxides (e.g., silica) are used in various industries [17]. Silica is a hydrophilic polymer, biocompatible, mechanically strong, thermally stable and resistant to microbes. Also, the pore size of this polymer can be controlled. Agarose along with its derivatives and compounds are also used in tissue engineering and regenerative medicine such as neurogenesis, angiogenesis, spermatogenesis, cartilage formation, bone regeneration, wound healing and artificial pancreas production [19]. It has been reported that it is challenging to control the degradation rate of alginate hydrogel to match follicle growth, and the stiffness of the polymer can have a negative effect on further follicle growth [24]. 
Fibrin is a non-globular fibrous protein that polymerizes a network to trap cells in the blood coagulation process. Fibrinogen is a 340-kDa soluble protein that is polymerized to fibrin in the presence of calcium by thrombin, which is an active enzyme [26]. Fibrin is a biocompatible and biodegradable material that can provide cells with an extracellular matrix similar to natural tissue and improve their interaction with scaffolds, their adhesion and proliferation.
Polyethylene glycol is a non-toxic, hydrophilic and biologically neutral substance. It is a synthetic biocompatible polymer approved by the US Food and Drug Administration (FDA) and has been widely used in tissue engineering and regenerative medicine. Polyethylene glycol is used to modify proteins and glycoproteins in combination with soluble fibrinogen. The polyethylene glycol/fibrinogen hydrogel can provide a structure for the culture of different cells and prevent the biodegradation of materials.
In tissue engineering, decellularized extracellular matrix has a significant potential to increase the regeneration of different organs such as liver, kidney and heart. It is also ​​widely used for reproductive tissue engineering to maintain the structure and function of the reproductive tissues. Recently, emerging studies have been conducted on the application of 3D printing in reproductive medicine. For example, one study used a 3D gelatin scaffold (Bioink) and created a bioprosthetic ovary after separating the follicle. The results showed that the follicles can survive, become vascular and even maintain ovarian function (ovulation) and fertility after transplantation [25].
The human amniotic membrane has many features that make it a promising protective layer. This membrane has been potentially used in many tissue engineering studies. It is known that the amniotic basement membrane, even in its decellularized form, is surrounded by basement membrane and stroma rich in collagen and glycosaminoglycans. In addition, this membrane is able to multiply and support different types of epithelial and stromal cells [53].

Uterine tissue engineering
Allogeneic uterine transplantation has been introduced as a potential treatment for infertility [55]. The first live birth from a transplanted uterus was reported in 2014 by Bernstrom et al [56]. Although this transplantation is a promising approach, it faces significant limitations, including the shortage of organ donors and the need for long-term immunosuppressive therapy [57]. One of the first efforts in the regeneration of uterine tissue is the grafting of artificial materials, including polytetrafluoroethylene, polyether urethane, poly (4-methylpentene), polyacrylate, polyamide derivatives, polyanhydride, polybenzoxazole, and poly (L-lactide) in a rat model [59]. In one study, basic fibroblast growth factor was loaded into collagen scaffolds and then transplanted into a rat whose uterine horn was severely damaged. The presence of fibroblast growth factor in the scaffold improved the vascularization process of endometrial and myometrial cells and pregnancy occurred in rats [64]. An alternative option for uterine tissue reconstruction is 3D printing of the uterus, which is gradually being used to create a scaffold in tissue engineering. The 3D printing method is a promising approach for uterine tissue engineering, because it has the potential to reproduce uterine structures, including vessels, completely without the need for tissue decellularization [72]. Another method is microfluidic technique. In a study using microfluidic technique, an artificial uterus consisting of 3 layers was prepared, the first layer was made of polydimethylsiloxane, the second layer of a porous polycarbonate membrane covered with gelatin and endometrial cells, and the third layer of polydimethylsiloxane. The results showed that the artificial uterus created by this method in rats was effective for up to 8 days [75].

Conclusion
Tissue engineering approaches as new alternative treatment methods, by integrating biological materials, cells and factors, have brought new hope in the treatment of functional defects of female reproductive organs/tissues. These strategies try to correct the abnormalities of the reproductive organs by accurately simulating the microenvironment of the reproductive organs. Also, the use of these strategies provides the possibility of evaluating the effects of biological and chemical factors such as hormones, growth factors and drugs to solve congenital and acquired disorders.

Ethical Considerations

Compliance with ethical guidelines
There were no ethical considerations to be considered in this research.

Funding
This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors.

Authors' contributions
Conceptualization, study design and initial draft preparation: Ali Talebi, Tayebeh Sadat Tabataba'i and Zahra Khosravizadeh; Data collection and analysis: Majid Salehi, Morteza Alizadeh and Zahra Nikoozad; Critical revision: Tayebeh Sadat Tabataba'i and Ali Talebi.  

Conflicts of interest
The authors declared no conflict of interest.




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