Elective single embryo transfer is rapidly becoming the standard of care in assisted reproductive technology for patients under the age of 35 years with a good prognosis. Clinical pregnancy rates have become increasingly dependent on the selection of a single viable embryo for transfer, and diagnostic techniques facilitating this selection continue to develop. Current progress in elucidating the extracellular vesicle and microRNA components of the embryonic secretome is reviewed, and the potential for these findings to improve clinical embryo selection discussed. Key results have shown that extracellular vesicles and microRNAs are rapidly detectable constituents of the embryonic secretome. Evidence suggests that the vesicular population is largely exosomal in nature, secreted at all stages of preimplantation development and capable of traversing the zona pellucida. Both extracellular vesicle and microRNA concentrations within the secretome are elevated for blastocysts with diminished developmental competence, as indicated either by degeneracy or implantation failure, whereas studies have yet to firmly correlate individual microRNA sequences with pregnancy outcome. These emerging correlations support the viability of extracellular vesicles and microRNAs as the basis for a new diagnostic test to supplement or replace morphokinetic assessment.

对于 35 岁以下预后良好的患者，选择性单胚胎移植正迅速成为辅助生殖技术的护理标准。临床妊娠率越来越依赖于选择单个可行胚胎进行移植，并且促进这种选择的诊断技术不断发展。综述了阐明胚胎分泌组的细胞外囊泡和 microRNA 成分的当前进展，并讨论了这些发现改善临床胚胎选择的潜力。主要结果表明，细胞外囊泡和 microRNA 是胚胎分泌组的可快速检测成分。有证据表明，囊泡群体本质上主要是外泌体，在胚胎植入前发育的所有阶段分泌，能够穿过透明带。对于发育能力减弱的囊胚，分泌组中的细胞外囊泡和 microRNA 浓度均升高，如退化或着床失败所表明的，而研究尚未将单个 microRNA 序列与妊娠结果牢固地关联起来。这些新出现的相关性支持细胞外囊泡和 microRNA 的可行性，作为补充或替代形态动力学评估的新诊断测试的基础。而研究尚未将个体 microRNA 序列与妊娠结果牢固关联起来。这些新出现的相关性支持细胞外囊泡和 microRNA 的可行性，作为补充或替代形态动力学评估的新诊断测试的基础。而研究尚未将个体 microRNA 序列与妊娠结果牢固关联起来。这些新出现的相关性支持细胞外囊泡和 microRNA 的可行性，作为补充或替代形态动力学评估的新诊断测试的基础。