Organoids in endometrial diseases: from bench to bedside.

Abstract

The endometrium, a dynamic tissue of paramount importance to female reproductive health, undergoes cyclic remodeling governed by hormonal signals.Endometrial disorders have a relatively high incidence rate and exert a considerable influence on women's quality of life; however, their underlying mechanisms remain incompletely understood. While organoid technology has revolutionized the modeling of human organs, its application in endometrium-related research has lagged behind that of other organ systems. Endometrial organoids (EnOs) possess considerable potential to replicate tissue-specific functions and disease phenotypes. Yet, a systematic synthesis of their development, characterization, and translational utility is still lacking. This review systematically outlines recent advances in EnOs generation and culture techniques, emphasizing how these models recapitulate key endometrial features. We further explore the application of EnOs in modeling disease mechanisms, highthroughput drug screening, and personalized treatment strategies, offering novel insights into endometrial pathophysiology beyond those provided by conventional twodimensional models. EnOs represent a promising platform for advancing precision medicine in gynecology. Despite challenges related to standardization and clinical translation, continued refinement of EnOs systems will deepen our understanding of endometrial biology and accelerate the development of targeted therapies for endometrial diseases.