Utilization of MSC-Derived Extracellular Vesicles and Bioscaffolds in Enhancing Oocyte In Vitro Maturation and Culture: A Review.

Failure in germ cells development and oocyte maturation remains a significant challenge in assisted reproductive technologies (ART) and can lead to feltilization failure and poor embryo quality. Rescue in vitro maturation (R-IVM) offers a promising approach to improve the reproductive outcomes in such cases. Mesenchymal stem cells-derived exosomes, have demonstrated therapeutic potential for both oocytes and granulosa cells. However, their effects on immature oocytes under R-IVM remain largely unexplored. Furthermore, incorporating exosomes into bioscaffolds may provide controlled release system, enhancing stability within IVM and in vitro culture (IVC) environments. This review evaluates the current evidence regarding the effects of MSC-derived exosomes on oocyte and granulosa cell function and explores the potential of exosome-loaded scaffolds to optimize IVM outcomes, offering new strategies for enhanced reproductive success. Recent findings indicate that bioscaffolds composed of appropriate polymers with high exosome encapsulation efficiency and a release window of 24-48 h can mimic the in vivo environment and support the maturation of oocytes and embryos in IVM/IVC systems.