{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T03:28:51Z","timestamp":1791084531891,"version":"4.1.0"},"reference-count":42,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Appropriate Technology Promotion Program of the Wuxi Municipal Health Commission","award":["T202452"],"award-info":[{"award-number":["T202452"]}]},{"name":"General Research Project of Wuxi Municipal Health Commission","award":["M202529"],"award-info":[{"award-number":["M202529"]}]},{"name":"Jiangsu Commission of Health Scientific Research Project","award":["Z2024001"],"award-info":[{"award-number":["Z2024001"]}]},{"name":"\u201cThree Famous\u201d Strategic Leading Talent Program of the Wuxi Maternity and Child Health Hospital","award":["LY2023002"],"award-info":[{"award-number":["LY2023002"]}]},{"name":"Wuxi Association for Science and Technology Soft Science Research Project","award":["KX-25-A18"],"award-info":[{"award-number":["KX-25-A18"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      This study investigates metabolic profiles in follicular fluid of patients with endometriosis (EM), polycystic ovary syndrome (PCOS), tubal blockage (TB), and unexplained infertility (UEI), assessing their associations with follicular development and\n                      <jats:italic>in vitro<\/jats:italic>\n                      fertilization (IVF) outcomes. It aims to identify metabolic alterations and potential biomarkers for EM diagnosis and personalized reproductive strategies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Follicular fluid samples were collected from 12 infertility patients (3 EM, 3 PCOS, 3 TB, and 3 UEI) undergoing IVF. Metabolomic profiling was performed using liquid chromatography-mass spectrometry (LC-MS), followed by pathway enrichment analysis to identify key metabolic pathways. Statistical analyses were conducted to compare metabolic profiles across groups, assess correlations with follicular development rate (FDR), and evaluate potential biomarkers for EM diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>EM patients showed significant metabolic changes, including reduced steroid biosynthesis and elevated thiamine metabolism metabolites, linked to lower FDR. Oxidative stress markers (3-chloro-L-tyrosine, 8-oxoerythraline) were elevated and negatively correlated with FDR. A predictive model identified D-mannosamine, D-galacturonic acid, and 3-chloro-L-tyrosine as potential EM biomarkers with high diagnostic accuracy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study reveals distinct metabolic disruptions in the follicular fluid of EM patients, particularly in steroid biosynthesis and thiamine metabolism pathways, which are linked to impaired follicular development. The identification of specific metabolites as potential biomarkers for EM provides a foundation for developing diagnostic approaches that minimize the need for additional invasive procedures and support personalized assisted reproductive technology (ART) strategies. This pilot study requires further validation to confirm these findings and translate them into clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.20786","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T08:41:25Z","timestamp":1770712885000},"page":"e20786","source":"Crossref","is-referenced-by-count":3,"title":["Metabolomic profiling of follicular fluid reveals unique pathways in endometriosis and infertility etiologies: a pilot study"],"prefix":"10.7717","volume":"14","author":[{"given":"Ping","family":"Yu","sequence":"first","affiliation":[{"name":"Center of Reproductive Medicine, Women\u2019s Hospital of Jiangnan University, Wuxi Maternity and Child Health Care Hospital, Wuxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dandan","family":"Chen","sequence":"additional","affiliation":[{"name":"Wuxi School of Medicine, Jiangnan University, Wuxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deshen","family":"Han","sequence":"additional","affiliation":[{"name":"Wuxi School of Medicine, Jiangnan University, Wuxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Jin","sequence":"additional","affiliation":[{"name":"Center of Reproductive Medicine, Women\u2019s Hospital of Jiangnan University, Wuxi Maternity and Child Health Care Hospital, Wuxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhong","family":"Li","sequence":"additional","affiliation":[{"name":"Wuxi School of Medicine, Jiangnan University, Wuxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fu","family":"Wei","sequence":"additional","affiliation":[{"name":"Center of Reproductive Medicine, Guigang City People\u2019s Hospital, Guigang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Center of Reproductive Medicine, Women\u2019s Hospital of Jiangnan University, Wuxi Maternity and Child Health Care Hospital, Wuxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4443","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"issue":"1","key":"10.7717\/peerj.20786\/ref-1","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1186\/s13048-021-00885-y","article-title":"Lipidomics analysis of human follicular fluid form normal-weight patients with polycystic ovary syndrome: a pilot study","volume":"14","author":"Ban","year":"2021","journal-title":"Journal of Ovarian Research"},{"issue":"4","key":"10.7717\/peerj.20786\/ref-2","doi-asserted-by":"publisher","first-page":"CD008189","DOI":"10.1002\/14651858.CD008189.pub3","article-title":"Preconception lifestyle advice for people with infertility","volume":"4","author":"Boedt","year":"2021","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"10.7717\/peerj.20786\/ref-3","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1093\/humupd\/dmx023","article-title":"Metabolomics as a tool to identify biomarkers to predict and improve outcomes in reproductive medicine: a systematic review","volume":"23","author":"Bracewell-Milnes","year":"2017","journal-title":"Human Reproduction Update"},{"key":"10.7717\/peerj.20786\/ref-4","doi-asserted-by":"publisher","first-page":"18645","DOI":"10.1021\/acs.analchem.3c02924","article-title":"Current practices in LC-MS untargeted metabolomics: a scoping review on the use of pooled quality control samples","volume":"95","author":"Broeckling","year":"2023","journal-title":"Analytical Chemistry"},{"key":"10.7717\/peerj.20786\/ref-5","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1007\/s11306-019-1481-x","article-title":"NMR metabolic profiling of follicular fluid for investigating the different causes of female infertility: a pilot study","volume":"15","author":"Castiglione\u00a0Morelli","year":"2019","journal-title":"Metabolomics"},{"key":"10.7717\/peerj.20786\/ref-6","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.biochi.2020.01.008","article-title":"Moderately elevated first trimester fasting plasma total homocysteine is associated with increased probability of miscarriage. 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