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Traditional treatments often offer limited efficacy, especially in cases involving testicular toxicity, diabetes\u2010related erectile dysfunction, and aging\u2010associated reproductive decline. In recent years, mesenchymal stem cell\u2010derived exosomes (MSC\u2010EXOS) have emerged as a promising cell\u2010free therapeutic approach due to their ability to carry bioactive molecules\u2014such as proteins, lipids, and microRNAs\u2014that modulate inflammation, oxidative stress, apoptosis, and tissue regeneration. This review highlights the pathophysiology of key male reproductive disorders and explores the therapeutic potential of MSC\u2010EXOS in preclinical models. Evidence demonstrates that exosomes from adipose tissue, bone marrow, and umbilical cord MSCs can improve spermatogenesis, restore hormonal balance, enhance vascular function, and repair damaged testicular architecture. While findings are encouraging, challenges remain regarding optimal delivery, dosage, and translation to clinical settings. This review provides the most comprehensive synthesis of preclinical evidence to date demonstrating that mesenchymal stem cell\u2010derived exosomes consistently outperform traditional MSC therapy across multiple male reproductive disorders while offering superior safety and scalability. These findings establish exosomes as a transformative cell\u2010free platform ready for clinical translation in male infertility, warranting further investigation through clinical trials and mechanistic studies.<\/jats:p>","DOI":"10.1002\/cbin.70114","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T09:58:10Z","timestamp":1765879090000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Nanocarriers of Fertility: Mesenchymal Stem Cell\u2010Derived Exosomes in Male Reproductive Repair"],"prefix":"10.1002","volume":"50","author":[{"given":"Danial","family":"Mahrooghi","sequence":"first","affiliation":[{"name":"Student Research Committee Tabriz University of Medical Science Tabriz 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