Implantation of the embryo is a rate‐limiting step for a successful pregnancy, and it requires an intricate crosstalk between the embryo and the endometrium. Extracellular vesicles (EVs) are membrane‐enclosed, nano‐sized structures produced by cells to mediate cell to cell communication and modulate a diverse set of biological processes. Herein, we review the involvement of EVs in the process of embryo implantation and endometrial diseases. EVs have been isolated from uterine fluid, cultured endometrial epithelial/stromal cells and trophectodermal cells. The endometrial epithelial and stromal/decidual cell‐derived EVs and its cargo are internalized bythe trophoblast cells, and they regulate a diverse set of genes involved in adhesion, invasion and migration. Conversely, the embryo‐derived EVs and its cargo are internalized by epithelial and immune cells of the endometrium for biosensing and immunomodulation required for successful implantation. EVs have also been shown to play a role in infertility, recurrent implantation failure, endometriosis, endometritis and endometrial cancer. Further research should set a stage for EVs as non‐invasive “liquid biopsy” tools for assessment of endometrial health.

中文翻译：

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胚胎植入中的细胞外囊泡和子宫内膜疾病

胚胎植入是成功怀孕的限速步骤，它需要胚胎和子宫内膜之间复杂的串扰。细胞外囊泡 (EV) 是由细胞产生的膜封闭的纳米级结构，用于介导细胞间通讯并调节多种生物过程。在此，我们回顾了 EVs 在胚胎着床和子宫内膜疾病过程中的参与。EVs 已从子宫液、培养的子宫内膜上皮/基质细胞和滋养外胚层细胞中分离出来。子宫内膜上皮和基质/蜕膜细胞衍生的 EV 及其货物被滋养层细胞内化，它们调节涉及粘附、侵袭和迁移的多种基因。反过来，胚胎衍生的 EV 及其货物被子宫内膜的上皮细胞和免疫细胞内化，用于成功植入所需的生物传感和免疫调节。EVs 也已被证明在不孕症、复发性植入失败、子宫内膜异位症、子宫内膜炎和子宫内膜癌中发挥作用。进一步的研究应该为 EV 作为评估子宫内膜健康的非侵入性“液体活检”工具奠定基础。