P-354 The impact of endometriosis on oocyte aging: Klotho and TERT expression in Cumulus cells

Abstract Study question Does endometriosis affect the expression of Klotho and Telomerase reverse transcriptase (TERT) in Cumulus cells and potentially accelerate oocyte aging? Summary answer Endometriosis significantly reduces Klotho and TERT expression in Cumulus cells, suggesting a link to accelerated oocyte aging. What is known already Endometriosis is a chronic gynecological disorder associated with infertility, potentially due to impaired oocyte quality. Cumulus cells, which surround and support the oocyte, share similar biological characteristics with oocytes. Direct analysis of oocytes is limited by the invasive nature of sampling; thus, Cumulus cells offer a non-invasive and reliable alternative for studying molecular mechanisms affecting oocyte quality in endometriosis patients. The Klotho gene, an anti-aging marker, and TERT, a regulator of telomere maintenance, are critical for preserving oocyte health. Studies have shown that Klotho and TERT interact indirectly to exert anti-aging effects. Study design, size, duration This case-control study was conducted from 2023 to 2024, involving 50 participants (25 endometriosis patients and 25 non-endometriosis controls). Cumulus cells were collected during assisted reproductive procedures, and the expression of Klotho and TERT genes was analyzed using quantitative Real-Time PCR. Participants/materials, setting, methods Cumulus cells were isolated from 25 endometriosis patients and 25 age-matched controls (mean age ∼34.5 years) undergoing assisted reproduction. RNA was extracted from the Cumulus cells, and after cDNA synthesis, gene expression analysis was performed using Real-Time PCR. Statistical differences in gene expression levels between groups were assessed using the non-parametric Mann-Whitney test. Main results and the role of chance Quantitative mRNA expression of Klotho and TERT were determined by real-time PCR technique. Gene expression data were analyzed based on 2^(-ΔΔCt) to estimate the relative fold change value. P-value less than 0.05 was considered statistically significant. The expression levels of Klotho and TERT were significantly lower in Cumulus cells from endometriosis patients compared to controls (P < 0.05). These findings suggest that reduced expression of Klotho and TERT in Cumulus cells may contribute to accelerated oocyte aging in endometriosis patients, highlighting their potential role in aging-related mechanisms. Limitations, reasons for caution A limitation of this study is the relatively small sample size, which may affect statistical power. Additionally, while Klotho and TERT are key regulators of cellular aging, investigating other aging-related genes, including those involved in oxidative stress and mitochondrial function, could provide a more comprehensive understanding of endometriosis-related oocyte aging. Wider implications of the findings These findings suggest that endometriosis negatively affects oocyte quality by downregulating key longevity-related genes. This molecular disruption may contribute to reduced fertility in affected women. Identifying these alterations in Cumulus cells provides valuable insights into the mechanisms of endometriosis-related infertility and may help refine diagnostic and therapeutic approaches. Trial registration number No