Extracellular vesicles (EVs) are small membrane-bound particles with nanoscale dimensions that are released by various cell types, ranging in size from approximately 30–150 nm. EVs carry a diverse cargo of bioactive materials including proteins, DNA fragments, mRNA, small RNAs, lipids, and metabolites, which can be transferred from donor cells to recipient cells, leading to phenotypic and functional changes in the recipient cells (Buschmann et al., 2018, Hou and Chen, 2021). Historic nomenclatures and subtypes for EVs have been proposed based on factors such as size, biogenesis pathway, cargo, cellular origin, and function (Forder et al., 2021). Tumor-derived EVs, which are abundantly produced in the tumor microenvironment (TME), are implicated in promoting tumor metastasis through diverse mechanisms, such as stimulating cancer cell proliferation, inhibiting apoptosis, establishing a premetastatic niche, transmitting information between cells, and regulating drug resistance (Jafari et al., 2021). Therefore, tumor-derived EVs also represent a potential source for the discovery of novel cancer biomarkers and therapeutic targets (Shao et al., 2018).

Notably, there are many similarities between tumor and pregnancy in biological manifestations (Kazemi et al., 2021). Both trophoblasts and cancer cells share properties such as the ability to invade healthy tissues, form new blood vessels, and create an immunosuppressive environment. Both tumors and embryos contain nonself components and need to evade immune responses in their respective microenvironments. Inactivation of the maternal immune response towards the embryo at the placental-maternal interface is crucial for successful embryonic development (Das and Kale, 2020). Emerging evidence suggests that EVs and their molecular cargos at the maternal-fetal interface play a pivotal role in the success of embryo implantation and pregnancy (Szuszkiewicz et al., 2022). EVs are now recognized as important mediators of angiogenesis, invasion, and immunosuppression in both pregnancy and cancer.

In this review article, we provide an overview of EVs, their types, and composition, with a specific focus on their role in tumors and TME. We highlight the similarities between tumor growth and embryonic development processes, drawing analogies between tumor-derived EVs and placental EVs, and between the endometrium and the TME. We explore the crucial role of EVs in mediating communication between the placenta and the endometrium, as well as between the endometrium and the placenta. Furthermore, we discuss the current applications and prospects of EVs in related fields, describe the limitations of current studies, and propose directions for further research.