The lipidome of endometrial fluid differs between implantative and non-implantative IVF cycles.

ObjectiveTo characterize the most relevant changes in the lipidome of endometrial fluid aspirate (EFA) in non-implantative cycles.DesignLipidomics in a prospective cohort study.SettingsReproductive unit of a university hospital.PatientsTwenty-nine women undergoing an IVF cycle. Fifteen achieved pregnancy and 14 did not.InterventionEndometrial fluid aspiration immediately before performing embryo transfer.Main outcome measuresClinical pregnancy rate and lipidomic profiles obtained on an ultra-high performance liquid chromatography coupled to time-of-flight mass spectrometry (UHPLC-ToF-MS)-based analytical platform.ResultsThe comparative analysis of the lipidomic patterns of endometrial fluid in implantative and non-implantative IVF cycles revealed eight altered metabolites: seven glycerophospholipids and an omega-6 polyunsaturated fatty acid. Then, women with a non-implantative cycle were accurately classified with a support vector machine algorithm including these eight lipid metabolites. The diagnostic performances of the algorithm showed an area under the receiver operating characteristic curve, sensitivity, specificity, and accuracy of 0.893 ± 0.07, 85.7%, 80.0%, and 82.8%, respectively.ConclusionA predictive lipidomic signature linked to the implantative status of the endometrial fluid has been found.