Metabolomic analysis of follicular fluid in women with endometriosis

Background: Endometriosis (EMS) is a benign gynecologic disease defined as ectopic proliferation of endometrial gland and stroma.Although the strong relationship between EMS and infertility is well known, its mechanism is still a conundrum.Recently, metabolomics has been spotlighted as a tool to elucidate the etiology, pathophysiology and mechanism of various diseases.Despite follicular fluid (FF) provides the microenvironment for follicular development and affects the quality of oocytes, there are only a limited number of metabolomic studies analyzing FF in EMS.The aim of this study is comparing the metabolomic and microbiome composition of FF of unilateral ovarian EMS with non-EMS patients.Method: Ten women receiving oocyte retrieval were enrolled prospectively from July 2021 to July 2022 at Seoul National University Bundang Hospital.Five patients were diagnosed with unilateral EMS and the other five patients were non-EMS control group.In EMS group, FF from EMS-affected ovary was collected.Targeted quantitative metabolomics kit, which can detect 188 metabolites, and twenty bile acid (BA) quantification kit are used for metabolomic analysis.Multivariate analysis (principal component analysis) was performed to identify discriminative the differences of composition.Result: There were six metabolites with statistical differences.In EMS group, acylcarnitine propenoylcarnitine (C3:1) was significantly increased, whereas