Metabolic Profile of Follicular Fluid in Patients with Ovarian Endometriosis Undergoing IVF: a Pilot Study

Research question: What are the metabolic characteristics of follicular fl uid in patients with ovarian endometriosis undergoing IVF? Design: This was an exploratory cohort study on endometriosis. In total, 19 infertile patients with ovarian endometriosis diagnosed by laparoscopy, and 23 controls matched in terms of age and body mass index (women with infertility due to male or tubal factors) were enrolled in this study. All patients underwent IVF treatment with a gonadotrophin-releasing hormone antagonist protocol, and follicular fl uid was collected at oocyte retrieval. The metabolomics of follicular fl uid samples was analysed using an ultra-high-performance liquid chromatography Orbitrap Exploris mass spectrometer (UHPLC-OE-MS). The best combination of biomarkers was selected by performing stepwise logistic regression analysis with backward elimination. Results: Fifteen metabolites were identi fi ed as biomarkers associated with endometriosis. A fi nal model containing 8-hydroxy-2deoxyguanosine, biotin, n-acetyl-L-methionine and n-methylnicotinamide was constructed. Receiver operating characteristic analysis con fi rmed the value of these parameters in diagnosing endometriosis, with sensitivity of 94.7% and speci fi city of 95.7%. Enrichment analysis via the Kyoto Encyclopedia of Genes and Genome showed that 15 metabolites were enriched in eight metabolic pathways. Conclusion: Metabolomics based on UHPLC-OE-MS effectively characterized the metabolomics analysis of follicular fl uid in patients with ovarian endometriosis. These fi ndings may provide a new basis for better understanding of how diseases progress, and for the discovery of new biomarkers.