A Review on Treatment of Premature Ovarian Insufficiency: Characteristics, Limitations, and Challenges of Stem Cell versus ExosomeTherapy

Table 3

Overall comparison description of the stem cell- versus exosome therapy in POI.

Effects, limitations & challenges	Type of treatment
	Mesenchymal stem cell (MSC)	MSCs-derived exosome	Ref
Antiapoptotic and anti-inflammatory effects			[28, 33, 52]
Recovery of the secretion of the disturbed hormones			[14, 15, 33]
Recovery of folliculogenesis			[14, 15, 66]
Follicle maturation			[19, 22]
Decreasing oxidative damage, increasing oxidative protection			[28, 53]
Requiring to prolong the cell survival rate in vivo			[33]
Promoting the ovarian angiogenesis			[12, 35, 55]
Requiring the adequate cell sourcing			[42, 43]
Safety concern			[3, 15, 55]
Follow up the long-term effect of transplanted cells/cargo			[55, 70]
Requiring to standard isolation and characterization methods			[45]
Requiring to standard the administration method			[14, 71]
Unknown administration frequency			[13, 71]
Undetermined fate			[13, 14, 42, 43]
Undetermined pharmacokinetics in vivo			[13]
Tumorigenic potential		?	[11, 13–15]
Requiring to understand the exact mechanism			[17, 18, 44, 56, 61]
The effective dose requires further study for clinical trials			[32, 38, 40]
Increasing the yield			[52]
Needing to increase the production efficiency			[52]

The asterisk (^∗) indicates confirmation for each statement, while the question mark (?) indicates that there is no definitive answer.