Novel therapeutic aspects of stem cell-derived extracellular vesicles in female reproductive disorders

Infertility affects millions of women worldwide, with causes ranging from ovarian dysfunction to endometrial disorders. Conventional treatments, such as hormone therapy and assisted reproductive technologies (ART), often have limited success and significant side effects. Stem cell-derived extracellular vesicles (EVs) have emerged as a promising alternative, offering therapeutic potential through their cargo of proteins, nucleic acids, and bioactive molecules that regulate tissue repair and regeneration. This review explores the role of EVs in addressing female infertility by enhancing ovarian follicle development, improving endometrial receptivity, and mitigating inflammation or fibrosis in reproductive tissues. We summarise preclinical and clinical evidence supporting EV-based therapies, discuss key mechanisms of action, and highlight challenges in translation, including standardisation, scalability, and safety. By evaluating current advancements and future prospects, this review highlights the experimental potential of EVs as a novel, cell-free approach under investigation for restoring fertility in women.