An update on current challenges of extracellular vesicle therapy in reproductive complications: A narrative review

In recent decades, cell-free therapies, such as extracellular vesicle (EV) applications, have emerged as effective alternatives for treating various pathologies that lead to male and female infertility. Among different types of EVs, exosomes, which range from 30 to 150 nm, are released by nearly all cell types under both physiological and pathological conditions. The exchange of exosomes facilitates active paracrine communication between donor and recipient cells by conveying signaling biomolecules and altering specific signaling pathways in target cell populations. Despite the numerous beneficial effects of exosome utilization, their clinical application still faces several challenges, including a lack of standardized isolation protocols, highly sensitive detection markers, sterility concerns, and the potential for dormant infections. This review article addresses the current challenges associated with the application of exosomes in female reproductive diseases in detail.