Mesenchymal Stem Cell-Derived Exosomes for Ovarian Reserve: A Systematic Review and Network Meta‑Analysis Based on Animal Studies.

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Reduced ovarian reserve is an important factor affecting female fertility, and exosomes from mesenchymal stem cell sources have shown great potential to enhance impaired ovarian reserve. However, there is a lack of comparisons and summaries of various sources of exosomes for treatment, and the optimal stem cell source is unknown. Databases of PubMed, Web of Science, Embase, China Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database, and China Biomedical Literature Service System (SinoMed) from inception to March 1, 2025. Two independent reviewers performed the literature search, identification, screening, quality assessment and data extraction. In total, 33 relevant studies involving 6 interventions were included after screening. Notably, human adipose mesenchymal stem cells-derived exosomes (hADMSCs-Exo) (standardized mean difference [SMD] = 8.99, 95% confidence interval[CI] [4.54, 13.45]), amniotic fluid mesenchymal stem cells-derived exosomes (AFMSCs-Exo)(SMD = 8.49, 95% CI [5.40, 11.57]), human umbilical cord mesenchymal stem cells-derived exosomes (hUCMSCs-Exo) (SMD = 3.70, 95% CI [2.05, 5.35]), and bone marrow mesenchymal stem cells-derived exosomes (BMSCs-Exo) (SMD = 3.55, 95% CI [1.74, 5.37]) demonstrated significant improvements in anti-Mullerian hormone (AMH) levels compared to the control group. AFMSCs-Exo and hADMSCs-Exo were probably the most effective i

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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