Extracellular vesicles and their role in endometrial receptivity in patients with recurrent implantation failure

Introduction. Despite advancements in assisted reproductive technologies (ART), the rates of successful implantation remain low (24—26%). Key factors include embryo quality and endometrial receptivity. One promising solution is the use of extracellular vesicles (EVs) secreted by the endometrium and embryo, which play a crucial role in regulating endometrial receptivity and implantation through the transport of microRNAs and other signaling molecules. Aim of the study. To analyze the influence of endometrial and embryonic extracellular vesicles on the implantation process in infertile patients and evaluate the potential of EVs for developing new diagnostic and therapeutic approaches in infertility treatment. Material and methods. A systematic literature review (PubMed, Scopus, 2018—2024) was conducted, focusing on studies investigating EVs and their role in implantation. Bibliographic method. For this article, we utilized literary sources from PubMed, MedLine, and the Cyberleninka database. The search depth extended up to 8 years. Articles addressing the impact of EVs on embryo implantation were selected, while those discussing the influence of EVs on fertilization and embryo development were excluded. Low-informative articles were rejected. Results. A total of 52 sources were analyzed and included in the study. The data provided show that BB plays a crucial role in regulating endometrial receptivity and the embryo implantation process, implementing intercellular information exchange using microRNA and other signaling molecules. Studies show that disruption of BB biosynthesis may be associated with unsuccessful implantations, and their repeated use in therapy may lead to an improvement in the ART program in patients with infertility. Conclusion. EVs represent a promising tool for diagnosing and correcting endometrial receptivity disorders and overcoming infertility. Further research is needed to develop clinical protocols.