Extracellular Vesicles in Implantation: Cross-Talk Between the Embryo and Endometrium

Extracellular vesicles (EVs), including exosomes and microvesicles, have emerged as pivotal mediators of intercellular communication. Embryo implantation is a critical process in early pregnancy and requires communication between the embryo and maternal uterus. EVs are important in coordinating the communication between the embryo and maternal uterus. This review explores EV biogenesis, molecular composition, and functional roles during implantation. It emphasizes the dynamic role of EVs in modulating the maternal-embryo dialogue, which is critical for establishing a receptive endometrium and facilitating successful implantation. EVs secreted by the embryo and endometrial cells have been shown to carry a diverse cargo of proteins, lipids, and miRNAs, which collectively influence key physiological processes, including immune tolerance, endometrial receptivity, and trophoblast invasion. EVs can be potential candidates as non-invasive biomarkers to assess the quality of embryos and uterine receptivity to enhance reproductive success. By providing a comprehensive overview of the current understanding of EVs in implantation, this chapter aims to highlight the significance of EVs in reproductive biology and their potential applications in improving fertility rates.