Hydrogel-based delivery systems loaded with natural active compounds for endometrial injury repair: a review of recent advances

Abstract This review highlights recent advancements in hydrogel-based delivery systems incorporating natural active compounds, particularly those derived from traditional Chinese medicine (TCM), for the repair of endometrial injuries. The endometrium, known for its exceptional regenerative capacity, often requires targeted therapeutic interventions when damaged. Conventional treatment approaches frequently exhibit limited efficacy, prompting growing interest in TCM-based strategies due to their favourable safety profiles and multifaceted therapeutic potential. However, clinical translation of TCM compounds remains challenging due to issues such as poor solubility and bioavailability. Recent innovations in biodegradable polymeric hydrogels offer a promising solution, enabling controlled release of bioactive compounds and enhancing therapeutic efficacy through mechanisms such as inflammation modulation, promotion of angiogenesis, and facilitation of epithelial regeneration. This review delves into the design principles, fabrication techniques, and current applications of natural and synthetic hydrogels in endometrial repair. While preclinical findings are encouraging, significant challenges persist, including biocompatibility optimization, standardization of TCM formulations, and precise control of hydrogel degradation. Future research should focus on developing innovative materials, integrating smart responsive systems, advancing personalized treatment modalities, and conducting large-scale clinical trials. Progress in this field will depend on interdisciplinary collaboration across biomaterials science, pharmacy, TCM, and clinical medicine, paving the way for clinical adoption of these advanced therapeutic strategies.