Extracellular Vesicles for the Maintenance of Pregnancies in Situations of Recurrent Spontaneous Abortion: Scoping...

Given the immune system's role in pregnancy, the immunomodulation generated by the use of extracellular vesicles (EVs) has been considered a possible treatment in situations of recurrent spontaneous abortion (RSA). Thus, this study evaluated, through a scoping review, the applicability of extracellular vesicle therapies for immunomodulation in maintaining pregnancies in situations of RSA.

This study was based on the Guidance for Conducting Systematic Scoping Reviews and was registered on the OSF Home platform. A systematic search was performed in the PubMed/MEDLINE, Scopus, and Cochrane Library databases up to June 2025 by two independent reviewers to answer the question addressed in the present review.

A total of 440 articles were analyzed, and after applying the eligibility criteria and excluding duplicate studies, three studies were selected. All three studies showed reduced embryonic absorption, promoting pregnancy maintenance. The EVs were extracted from trophoblasts, decidual stromal cells, or bone marrow stem cells, and administered intravenously, primarily, in dose of 100 or 200 µg. All EVs have immunomodulatory relevance in pregnancy, modifying the lymphocyte and cytokine patterns, and contributing to angiogenesis and trophoblast growth.

We conclude that EVs represent a potential area for the development of future therapies for pregnancies with RSA, and new studies are necessary to confirm these findings.