Follicular fluid extracellular vesicles (FF‑EVs) offer a promising strategy to improve ART outcomes by delivering bioactive cargo that regulates sperm function and fertilizing ability, and early embryonic development. Their effects are age‑dependent: young‑derived FF-EVs enhance spermatozoa motility and hyperactivation, while older‑derived EVs are ineffective. This effect may reflect age‑related differences in FF‑EV proteomic and lipidomic composition. Clinically, FF‑EV supplementation significantly increases fertilization and blastulation rates in women under 35 (p < 0.001), upregulates proliferation genes, and reduces cancellation rates in advanced maternal age without altering euploidy, confirming benefits without genetic risk. In addition, our research group is investigating the FF‑EVs role in regulating oocyte maturation in vitro following cumulus cell removal. A novel approach has been developed for FF‑EV application via subZP (zona pellucida) injection into immature oocytes. We demonstrated that FF‑EVs obtained following hCG trigger exhibit high efficacy in stimulating oocyte in vitro maturation, increasing the maturation rate to 73.5% compared to 33.3% in the control group (p>0,05). This confirms their potent ability to provide physiologically relevant conditions for final oocyte maturation under ovarian stimulation.

The development of FF‑EV‑based clinical applications represents an innovative direction that bridges fundamental research in cell biology with the practical needs of reproductive medicine.

Anastasiia Sysoeva is an embryologist and has PhD in Cell Biology. She is an ESHRE‑certified embryologist and an active member of the society, with an extensive track record of publications and international conference presentations. Anastasiia’s research interests include reproductive system extracellular vesicles, gametogenesis and embryogenesis, and cellular technologies in reproductive medicine. She believes in development, communication, and humanity, and strives to continuously expand an expertise by exploring her core research interests while also engaging with related disciplines to gain a deeper understanding of human reproduction. Her goal is to help more people give birth to healthy children and to investigate the unexplored intricacies of human fundamental biology.