The effect of exosomes on oocyte maturation

Aim: Numerous infertile patients face challenges in oocyte maturation during in vitro fertilization treatment. Hormonal dysregulation, mitochondrial dysfunction, abnormal organelle distribution within the ooplasm, and biological, genetic, and epigenetic factors lead to oocyte maturation arrest. Oocyte maturation involves the secretion of extracellular vesicles, known as exosomes, by surrounding granulosa cells into the follicular fluid. This review examines the mechanisms by which exosomes influence oocyte maturation, evaluates their effects on oocyte maturation in diverse female infertile patient groups, discusses the therapeutic potential of exosomes in oocyte maturation. Materials and Methods: Studies published up to September 2024 were collected from the PubMed database. The analysis methodology included the following keywords: exosome or extracellular vesicles or exosomes in reproductive medicine and oocyte maturation, diminished ovarian reserve, polycystic ovary syndrome, premature ovarian insufficiency and therapeutic potential of exosomes. This review focused on studies about exosomes in oocyte maturation and female infertility. The inclusion criteria for the studies were: studies involving patients diagnosed with (1) Premature ovarian insufficiency, (2) Diminished ovarian reserve, or (3) Polycystic ovary syndrome. Male factor infertility, tubal factor infertility, and endometriosis were excluded. Results: Existing literature demonstrates that exosomes exert crucial effects and a regulatory role on oocyte maturation. Exosomes modulate the processes of ovarian granulosa and cumulus cells to affect follicular development. Conclusion: The function of exosomes in oocyte maturation may be further clarified through detailed analysis of their specific proteins and therapeutic potential as a nascent alternative treatment for infertility, particularly in patients with diminished ovarian reserve.