Extracellular vesicles in female reproduction: from basic research to application

In vitro embryo production (IVEP) offers an alternative approach for fertility preservation, genetic improvement, and reproductive research. However, in vivo, the female reproductive tract constitutes a dynamic microenvironment that undergoes critical changes crucial to support oocyte maturation, fertilization and embryo development. During IVEP, the absence of maternal-gamete and later maternal-embryo cross-talk can compromises both fertility and embryo development as well as quality. Extracellular vesicles (EVs) derived from the maternal reproductive tract, such as those from follicular fluid, oviductal fluid and uterine fluid, have attracted increasing attention due to their ability to carry bioactive biomolecules and partially restore this bidirectional communication when supplemented during IVEP. Moreover, EVs hold the potential to serve as indicator of the physiological or pathological state of reproductive structures as well as serving as real-time biomarkers. In addition, several studies suggest that EVs offer multiples advantages over conventional synthetics carries, opening new frontiers for modern drug or nucleotide delivery systems. Therefore, this review aims to provide a comprehensive overview of EVs derived from female reproductive tract, exploring their potential applications and challenges in enhancing IVEP outcomes and fertility treatments.