Research question

Is there a follicular fluid-specific metabolic profile in deep infiltrating endometriosis (DIE) depending on the presence of an associated ovarian endometrioma (OMA) that could lead to the identification of biomarkers for diagnosis and prognosis of the disease?

Design

In this prospective cohort study, proton nuclear magnetic resonance (¹H-NMR) experiments were carried out on 50 follicular fluid samples from patients presenting with DIE, associated or not associated with an OMA, and 29 follicular fluid samples from patients with infertility caused by a tubal obstruction.

Results

Concentrations of glucose, citrate, creatine and amino acids such as tyrosine and alanine were lower in women with DIE than control participants, whereas concentrations of lactate, pyruvate, lipids and ketone bodies were higher. Metabolic analysis revealed enhanced concentrations of glycerol and ketone bodies in patients with OMA, indicative of an activation of lipolysis followed by beta-oxidation. Concentrations of lactate and pyruvate were increased in patients without OMA, whereas the concentration of glucose was decreased, highlighting activation of the anaerobic glycolysis pathway. Differences in concentrations of amino acids such as threonine and glutamine were also statistically relevant in discriminating between the presence or absence of OMA.

Conclusions

Results indicate a mitochondrial dysregulation in endometriosis phenotypes, with a modified balance between anaerobic glycolysis and beta-oxidation in OMA phenotypes that could affect the fertility of women with endometriosis. As the composition of the follicular fluid has been shown to be correlated with oocyte development and outcome of implantation after fertilization, these findings may help explain the high level of infertility in these patients.

中文翻译：

---

卵泡液代谢组因子宫内膜异位症表型而异

研究问题

根据相关卵巢子宫内膜异位症 (OMA) 的存在，深部浸润性子宫内膜异位症 (DIE) 中是否存在卵泡液特异性代谢特征，这可能导致鉴定用于疾病诊断和预后的生物标志物？

设计

在本前瞻性研究，质子核磁共振（¹ H-NMR）实验患者DIE呈递上进行50个卵泡液样品，相关联或不与OMA从不孕症患者造成相关联，并且29个卵泡液样品输卵管阻塞。

结果

与对照组相比，DIE 女性的葡萄糖、柠檬酸、肌酸和氨基酸（如酪氨酸和丙氨酸）浓度较低，而乳酸、丙酮酸、脂质和酮体的浓度较高。代谢分析显示，OMA 患者的甘油和酮体浓度升高，表明脂肪分解激活，然后是 β-氧化。没有 OMA 的患者的乳酸和丙酮酸浓度增加，而葡萄糖浓度降低，突出了无氧糖酵解途径的激活。诸如苏氨酸和谷氨酰胺之类的氨基酸浓度的差异在区分 OMA 的存在或不存在方面也具有统计学意义。

结论

结果表明，子宫内膜异位症表型中存在线粒体失调，OMA 表型中无氧糖酵解和 β-氧化之间的平衡发生改变，这可能会影响子宫内膜异位症女性的生育能力。由于卵泡液的成分已被证明与受精后的卵母细胞发育和着床结果相关，因此这些发现可能有助于解释这些患者的高水平不孕症。