The oxylipins profile and their associations with embryo quality of women with polycystic ovary syndrome: a prospective cohort study

This study was aim to investigate the oxylipins profile in the follicular fluid (FF) of women with PCOS and examine their associations with embryo quality. We conducted a targeted lipidomic study involving sixty-two cases of PCOS and age-matched controls (Cohort 1) <i>via</i> UHPLC–MS. Cohort 2 included sixty cases of PCOS and age-and-BMI-matched controls who were recruited for validation <i>via</i> targeted lipidomics. The associations between these oxylipins and baseline hormones as well as embryo quality in PCOS patients were analyzed. A total of 59 oxylipins were identified in the FF of PCOS patients. In the FF of PCOS patients in Cohort 1, the level of 16(17)-EpDPE, a product derived from docosahexaenoic acid (DHA), was greater than that in the control group, even after adjustment for age, BMI and multiple comparisons (<i>p</i> &lt; 0.001, adjusted <i>p</i> = 0.032). An increased concentration of 16(17)-EpDPE in women with PCOS was further validated in Cohort 2 (<i>p</i> &lt; 0.001, adjusted <i>p</i> = 0.044). In addition, compared with the control group, the PCOS group in Cohort 2 presented significantly lower levels of eicosapentaenoic acid (EPA)-derived oxylipins (18-HEPE), DHA-derived oxylipins (4-HDoHE, 16-HDoHE), linoleic acid(LA)-derived oxylipins (12,13-EpOME, 13-HODE and 9-oxoODE), and dihomo-gamma-linolenic acid(DGLA)-derived oxylipins (15-HETrE). Correlation analyses between oxylipin metabolites and clinical features revealed that 16(17)-EpDPE was negatively associated with the number of D3 good-quality embryos and positively associated the blood lymphocyte count. Three LA-derived oxylipins were associated with the serum AMH and leptin levels in the FF. Our study revealed distinct metabolic signatures in women with PCOS and identified 16(17)-EpDPE as a novel biomarker for PCOS and their D3 good-quality embryos count.