From biomolecules to breakthroughs: exosomes as next-generation theranostics in female infertility

Ahmed A Aldarmahi, Ahmed Aldarmahi, Shifan Khanday, Ehab S Taher, Ahmed Abdeen, Gamal Abdel Nasser Atia, Gamal A Atia, Dania A Mohammed, Dania Mohammed, Dina S Nasr, Rayan G Albarakati, Donia E Zaghamir, Donia Elsaid Fathi Zaghamir, Helal F Hetta, ‏Helal F. Hetta, Ahmed M Atwa, Kasim S Abass, Kasim Sakran Abass, Ekramy Elmorsy, Ekramy M Elmorsy, Abeer Alshambky, Mohamed A El-Sakhawy, Mohamed A. El‐Sakhawy, Ali H. El‐Far, Ali El-Far, Shimaa S Attia
Frontiers in cell and developmental biology · 2025 · vol. 13 , pp. 1605174 · doi:10.3389/fcell.2025.1605174 · PMID:41104019 · PMC12521274 · W4414713157
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This review details how exosomes, acting as intercellular messengers, offer both diagnostic and therapeutic potential for female infertility conditions by modulating reproductive processes and restoring homeostasis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This paper is a narrative review discussing exosomes (EXOs)—nanosized extracellular vesicles carrying RNA, proteins, enzymes, and lipids—as next-generation diagnostic and therapeutic “theranostics” for female infertility and related reproductive disorders. Drawing on high-level mechanistic literature, it describes how EXOs may influence endometrial regeneration, folliculogenesis, immune modulation, and angiogenesis via intercellular cargo transfer, and it evaluates isolation and engineering strategies (e.g., cargo loading, surface modification) alongside limitations such as lack of standardization, scalability challenges, and insufficient long-term safety data. A stated caveat is that advancing clinical translation requires further research to address these issues before implementation. Relevance to endometriosis: the review explicitly lists endometriosis among the female infertility disorders potentially addressable by exosome-based theranostics, framing EXOs as agents that could modulate tissue and immune processes relevant to endometrial pathology.

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Abstract

Female infertility and reproductive disorders represent a significant global health challenge, with complex etiologies often linked to impaired cellular communication, inflammation, and tissue dysfunction. Exosomes (EXOs), nanosized extracellular vesicles laden with bioactive molecules, have become recognized as significant transmitters of intercellular signaling in reproductive physiology and pathology. This review comprehensively discusses the dual diagnostic and therapeutic potential of EXOs in addressing female infertility disorders, such as endometriosis, polycystic ovary syndrome (PCOS), primary ovarian insufficiency (POI), Asherman syndrome, and gynecological cancers. We investigate the strategies whereby EXOs govern important activities like endometrial regeneration, folliculogenesis, immune modulation, and angiogenesis, while highlighting their role in restoring ovarian and uterine homeostasis. Advances in exosome isolation techniques, bioengineering strategies (e.g., cargo loading, surface modification), and scaffold-based delivery systems are critically evaluated for their capacity to enhance therapeutic precision and efficacy. Notwithstanding their potential, issues include standardization of isolation protocols, scalability, and long-term safety, which necessitate further research. By integrating molecular insights with translational innovations, this review underscores the clinical implementation of exosome-based therapeutics in revolutionizing reproductive medicine, offering new hope for personalized, non-invasive treatments in female fertility restoration.

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endometriosisinfertility

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