ABSTRACT
Objective To investigate whether the metabolites in follicular fluid can be used as indicators for predicting oocyte quality and embryos early development in patients with polycystic ovary syndrome (PCOS). Methods The study subjects were divided into four groups: lean control (LC) 30 cases, overweight (OW) 13 cases, lean PCOS (LP) 26 cases, and overweight PCOS (OP) 26 cases based on the Chinese criteria for body mass index (BMI) categories. The metabolic variance of follicular fluid from PCOS and controls was performed by liquid chromatography-mass spectrometry (LC-MS), and clinical characteristics, oocyte outcomes and differences of metabolites in follicular fluid of those patients have been compared by ANOVA. Furthermore, Pearson's correlation analysis was used to explore the correlation between oocyte fertilization rate, top-quality embryos rate and follicular metabolites. Results Compared to the LC group, oocytes retrieved and top-quality embryos rate were significantly increased, while the mature oocytes rate and fertilization rate decreased significantly in the OP group. A total of 236 metabolites were identified and quantified by metabolomics in follicular fluid. Compared with LC and OP groups, 19 metabolites showed statistically significant differences in PCOS group. Additionally, 7 metabolites were significant correlated with the fertilization rate or top-quality embryo rate respectively, most of which were lysophospholipids. Conclusion Several metabolites in the follicular fluid are significantly different between PCOS and healthy women. Among these, lysophospholipids are crucial for oocyte quality and early embryonic development, may serve as potential markers to evaluate the oocyte quality in PCOS patients.