# Identification of Proteins and MicroRNAs with Prognostic Value for Assisted Reproduction Technology Outcomes in Follicular Fluid of Women with Endometriosis: A Pilot Study

## TL;DR

This pilot study identifies proteins and microRNAs in follicular fluid that may predict ART outcomes in women with endometriosis.

## Contribution

The study identifies specific miRNAs and proteins in follicular fluid as potential biomarkers for ART success in endometriosis.

## Key findings

- GDF-9 and BMP-15 levels increased, while AMH mature protein decreased in endometriosis patients.
- miR145_1, miR320a_1, and miR125b-5p showed potential as predictors of endometriosis and biochemical pregnancy.
- The study highlights the role of dysregulated miRNAs in endometriosis-related infertility.

## Abstract

This study aims to identify molecular markers with prognostic value for biochemical pregnancy in follicular fluid (FF) samples from women with endometriosis after assisted reproductive technology (ART) intervention. Levels of growth differentiation factor-9 (GDF-9), bone morphogenetic protein-15 (BMP-15), and anti-Mullerian hormone (AMH) proteins were semi-quantified by Western blotting and microRNAs 20a_1, 145_1, 320a_1, 125-b-5p, 212-3p, and 199_a by qPCR in FF samples from women submitted to ART with a previous diagnosis of endometriosis (n = 20) or male factor infertility (controls) (n = 44). An increase in GDF-9 and BMP-15 and a decrease in AMH mature protein were observed, as well as an increase in miR20a_1 (p = 0.04), miR145_1 (p = 0.003), and miR320a_1 (p = 0.006) in FF samples collected from women with endometriosis compared with controls. A reduction was observed in miR125b-5p (p = 0.004) and 212-3p (p = 0.02) in endometriosis. Receiver operating characteristic (ROC) curve analysis indicated that miR125b-5p, miR212-3p, and miR-145_1 are potential predictors of endometriosis, and miR145_1 and miR320a_1 of biochemical pregnancy in controls. Although limited by a small sample size, the current study demonstrated alterations in AMH, BMP-15, GDF-9, and specific miRNA levels in FF samples harvested from women with endometriosis, emphasizing their potential roles in endometriosis-related infertility. These microRNAs, dysregulated in women with endometriosis, unveil their biomarker properties and their predictive value for ART success.