Use of extracellular vesicles from multipotent mesenchymal stromal cells in preparation for in vitro fertilization programs in patients with diminished ovarian reserve
07.11.2025
15:42
Russian researchers from the Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation, conducted a study aimed to evaluate the clinical efficacy of intraovarian injection of extracellular vesicles isolated from placental multipotent mesenchymal stromal cells in patients with diminished ovarian reserve undergoing in vitro fertilization (IVF).
This prospective randomized controlled trial (open-label design) included 100 women with a diminished ovarian reserve. Patients randomized to the study group (n=50) received intraovarian injections of extracellular vesicles before stimulation, whereas those in the control group (n=50) underwent standard stimulation. The primary outcome was the clinical pregnancy rate, and secondary outcomes included the number of retrieved and mature oocytes, number of 2PN zygotes, blastocysts, blastulation rate, and live births.
The study group showed a statistically significant increase in the number of mature oocytes (4.1 [1.3] vs. 1.5 [1.0], p<0.001), blastocysts (1.4 [0.6] vs. 0.8 [0.4], p<0.001), and blastulation rate (58.2% vs. 31.1%, p=0.008). The clinical pregnancy rate was 24% in the study group compared to 6% in the control group (RR=4.0; 95% CI 1.2–13.3), and the live birth rate was 18% in the study group and 2% in the control group (RR=9.0; 95% CI 1.2–68.4).
Intraovarian administration of extracellular vesicles from mesenchymal stromal cells in patients with diminished ovarian reserve enhances ovarian response, embryo quality, clinical pregnancy rates, and live birth rates in IVF. This technique shows high potential but requires confirmation through larger studies.
