Can iron serve as oocyte quality indicator in endometriosis?

Zhexin Ni, Yangshuo Li, Chaoqin Yu
In: The Innovation Medicine · 2025 · vol. 3(2) , pp. 100130 · doi:10.59717/j.xinn-med.2025.100130 · W4409958191
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This review examines how altered iron levels in follicular fluid may relate to diminished oocyte quality in endometriosis-associated infertility and discusses challenges for its clinical use.

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This paper is a perspective that synthesizes evidence on altered iron content in follicular fluid (FF) and corresponding oocyte quality outcomes in endometriosis-associated infertility, including proposed detection approaches and correlational findings. The authors report that dysregulated FF iron levels in endometriosis patients may be associated with diminished oocyte quality, drawing on prior mechanistic and observational studies. A key caveat emphasized is that translating FF iron content into a clinical evaluation indicator is hindered by multiple challenges, with calls for standardized detection and assessment protocols. This paper is centrally about endometriosis — it focuses on whether FF iron can function as an oocyte quality indicator in endometriosis-related infertility.

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Abstract

Endometriosis (EMs) is a significant cause of female infertility, and recent attention has focused on the relationship between iron levels in follicular fluid (FF) and oocyte quality. This perspective summarizes the characteristics of altered FF iron content and oocyte quality in EMs-associated infertility patients, along with detection methods and correlative studies. Current research indicates that dysregulated iron levels in the FF of EMs patients may be associated with diminished oocyte quality. However, the clinical utilization of FF iron content as an evaluation indicator faces multiple challenges. Future investigations should prioritize elucidating the regulatory mechanisms of iron homeostasis in the FF of EMs patients, establishing standardized detection and evaluation protocols, and providing novel insights for assisted reproductive therapies in EMs-related infertility cases.
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Abstract

Endometriosis (EMs) is a significant cause of female infertility, and recent attention has focused on the relationship between iron levels in follicular fluid (FF) and oocyte quality. This perspective summarizes the characteristics of altered FF iron content and oocyte quality in EMs-associated infertility patients, along with detection methods and correlative studies. Current research indicates that dysregulated iron levels in the FF of EMs patients may be associated with diminished oocyte quality. However, the clinical utilization of FF iron content as an evaluation indicator faces multiple challenges. Future investigations should prioritize elucidating the regulatory mechanisms of iron homeostasis in the FF of EMs patients, establishing standardized detection and evaluation protocols, and providing novel insights for assisted reproductive therapies in EMs-related infertility cases. -

References

[1] Li Y., He Y., Cheng W., et al. (2023). Double-edged roles of ferroptosis in endometriosis and endometriosis-related infertility. Cell Death Discov. 9:306. DOI:10.1038/s41420-023-01606-8 [2] Li A., Ni Z., Zhang J., et al. (2020). Transferrin insufficiency and iron overload in follicular fluid contribute to oocyte dysmaturity in infertile women with advanced endometriosis. Front Endocrinol. 11:391. DOI:10.3389/fendo.2020.00391 [3] Sanchez A. M., Papaleo E., Corti L., et al. (2014). Iron availability is increased in individual human ovarian follicles in close proximity to an endometrioma compared with distal ones. Hum. Reprod. 29:577−583. DOI:10.1093/humrep/det466 [4] Wu Y., Yang R., Lan J., et al. (2023). Iron overload modulates follicular microenvironment via ROS/HIF-1α/FSHR signaling. Free Radic. Biol. Med. 196:37−52. DOI:10.1016/j.freeradbiomed.2022.12.105 [5] Collodel G., Gambera L., Stendardi A., et al. (2023). Follicular fluid components in reduced ovarian reserve, endometriosis, and idiopathic infertility. Int. J. Mol. Sci. 24:2589. DOI:10.3390/ijms24032589 [6] Holmes-Hampton G. P., Tong W. H. and Rouault T. A. (2014). Biochemical and biophysical methods for studying mitochondrial iron metabolism. Methods Enzymol. 547:275−307. DOI:10.1016/b978-0-12-801415-8.00015-1 [7] Li H., Yue H., Li H., et al. (2025). High-throughput point-of-care serum iron testing utilizing machine learning-assisted deep eutectic solvent fluorescence detection platform. J. Colloid. Interface Sci. 680:389−404. DOI:10.1016/j.jcis.2024.11.110 [8] Wang F., Glenn A. J., Tessier A. J., et al. (2024). Integration of epidemiological and blood biomarker analysis links haem iron intake to increased type 2 diabetes risk. Nat. Metab. 6:1807−1818. DOI:10.1038/s42255-024-01109-5 [9] Ni Z., Li Y., Song D., et al. (2022). Iron-overloaded follicular fluid increases the risk of endometriosis-related infertility by triggering granulosa cell ferroptosis and oocyte dysmaturity. Cell Death Dis. 13:579. DOI:10.1038/s41419-022-05037-8 [10] Rodríguez-Varela C. and Labarta E. (2020). Clinical application of antioxidants to improve human oocyte mitochondrial function: A review. Antioxidants 9:1197. DOI:10.3390/antiox9121197 - ABOUT THIS ARTICLE Cite this article: Ni Z., Li Y. and Yu C. (2025). Can iron serve as oocyte quality indicator in endometriosis? The Innovation Medicine 3:100130. https://doi.org/10.59717/j.xinn-med.2025.100130 To request copyright permission to republish or share portions of our works, please visit Copyright Clearance Center's (CCC) Marketplace website at marketplace.copyright.com. - Figure 1. Challenges in assessing iron levels in follicular fluid

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endometriosisinfertility

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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