Extracellular vesicles as a potential diagnostic tool in assisted reproduction

Extracellular vesicles have emerged as a promising field of research for their potential to serve as biomarkers. In the pathophysiology of reproduction, they have attracted significant attention because of their diverse roles in gametogenesis and embryo-endometrial cross-talk. Advances in extracellular vesicle translational potential are herein reviewed with a particular focus in oocyte competence, semen quality diagnostics, embryo selection and detection of endometrial receptivity.

Specific miRNAs present in follicular fluid-derived extracellular vesicles have been associated with follicle development and oocyte maturation. Some proteins known to regulate sperm function and capacitation such as glycodelin, and CRISP1 have been found as overrepresented in semen exosomes isolated from severe asthenozoospermic compared to normozoospermic men. In vitro developed human embryos can secrete extracellular vesicles whose propitiousness for preimplantation genetic testing is being increasingly investigated. Endometrial cell-derived extracellular vesicles recovered from uterine flushings might represent a reservoir of molecular markers potentially exploited for monitoring the endometrial status.

Accumulated knowledge on extracellular vesicles deriving from endometrium, follicular fluid, embryos or male reproductive system may be translated to clinical practice to inform diagnostics in assisted reproduction technology (ART). Validation studies and technology developments are required to implement the profiling of extracellular vesicles as diagnostic tests in ART.