Deciphering the Molecular Messages of Extracellular Vesicles: A New Paradigm for the Diagnosis of Male and Female Infertility

Carmen Navarro, Panayiotis Zavos, Vanessa Alvarez.

Abstract

Infertility represents one of the most significant silent public health crises today [1,2]. Progressive alterations in seminal parameters [3,4], declining ovarian reserve [5] and an earlier onset of menopause [6] are shaping a scenario of accelerated reproductive decline globally [7,8]. Extracellular vesicles (EV) nanoscale membrane-bound particles secreted by virtually all cell types—carry molecular cargo including proteins, non-coding RNAs, lipids, and metabolites that directly reflect the physiological state of their cell of origin [9,10]. This systematic review synthesizes scientific evidence published between 2020 and 2025 regarding the utility of EV as diagnostic and prognostic biomarkers in male and female infertility [11-13]. Ultimately, these findings point toward a new paradigm of precision reproductive medicine based on interpreting each patient’s individual molecular profile [14,15].