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The association between E and infertility is clinically well recognized. For E patients to achieve a successful pregnancy, assisted reproductive technologies (ART) are considered as a treatment option. However, the impact of E on oocyte quality, its potential to be fertilized as well as pregnancy rates, is still under debate and with very few molecular clues explaining the clinical data. Alterations in protein-coding RNAs in cumulus cells (CCs), cells surrounding the oocytes and contributing to oocyte maturation, have been reported in E patients. But there is a lack of information regarding microRNAs (miRNAs), which control protein translation. Thus, we aimed: (1) to identify altered miRNA expression in CCs of E patients versus patients without the disease (control, C); and (2) to unveil if in E patients, CCs from fertilized oocytes display a different miRNA profile versus oocytes that failed fertilization. Small RNA-sequencing was performed on CCs from patients undergoing ART.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 85 differentially expressed (DE) miRNAs were identified in E versus C patients (FDR\u2009&lt;\u20090.05). In E patients, 25 DE miRNAs were found between fertilized oocytes and oocytes that failed fertilization, while 13 DE miRNAs in C patients (FDR\u2009&lt;\u20090.05). Comparisons among DE miRNAs highlighted three notable miRNA sets: Set (1) 35 DE miRNAs specific to E; Set (2) 27 DE miRNAs affected by both E and the potential to be fertilized; and Set (3) 6 DE miRNAs characteristic of a competent oocyte successfully fertilized despite the disease. Target gene analysis of DE miRNAs unveiled genes involved in oocyte meiosis, progesterone-mediated oocyte maturation pathway, embryo development, mitochondria and spindle alterations, calcium signaling, and oxidative stress.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>This study identified for the first time an altered miRNA signature in CCs of E patients, pointing towards compromised oocyte competence. Besides, in E patients, a characteristic CCs miRNA footprint for oocytes that can be successfully fertilized despite the disease has been revealed. The study charts new territory for non-invasive diagnosis and personalized treatments based on miRNAs to improve oocyte competence in E patients under ART treatments.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s40659-025-00641-2","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T10:19:24Z","timestamp":1758881964000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Endometriosis-associated infertility alters the microRNA signatures of cumulus cells with a particularly pronounced effect in oocytes that failed fertilization"],"prefix":"10.1186","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0495-7099","authenticated-orcid":false,"given":"Carmen","family":"Almi\u00f1ana","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Makieva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Bauersachs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara D.","family":"Saenz-de-Juano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Velasco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Cervantes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne R.","family":"Spalinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne E.","family":"Ulbrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte","family":"Leeners","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"issue":"2","key":"641_CR1","doi-asserted-by":"publisher","first-page":"hoac009","DOI":"10.1093\/hropen\/hoac009","volume":"2022","author":"CM Becker","year":"2022","unstructured":"Becker CM, Bokor A, Heikinheimo O, Horne A, Jansen F, Kiesel L, et al. 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