Zhang Wen, Chen Yidong, Han Bing, Li Rong, Ma Caihong, Qiao Jie
State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University, Third Hospital, Beijing, China.
National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Front Endocrinol (Lausanne). 2025 Aug 25;16:1625638. doi: 10.3389/fendo.2025.1625638. eCollection 2025.
This study explores the metabolic profiles in the peripheral blood of infertile patients with adenomyosis (ADM) to identify key metabolites affecting pregnancy outcomes in these patients undergoing frozen embryo transfer (FET). Our goal is to create a metabolite-based clinical prediction model for pregnancy outcomes in adenomyosis-associated infertility.
This prospective cohort study from the Reproductive Center at Peking University Third Hospital enrolled 94 infertile patients with adenomyosis and control (CTRL) patients undergoing FET. We divided these patients into four groups based on clinical pregnancy success: ADM-Success, ADM-Fail, CTRL-Success, and CTRL-Fail. We collected peripheral blood on the day of embryo transfer and analyzed metabolites using ultrahigh-performance liquid chromatography-tandem mass spectrometry. We compared metabolome differences among the four groups using bioinformatics and evaluated the diagnostic performance of metabolites for predicting pregnancy outcomes using receiver operating characteristic curves.
We found the metabolic differences between ADM-Success group and ADM-Fail group, and established a "5 metabolites + age" panel (5 metabolites combined with woman's age panel), which could effectively predict pregnancy outcomes of adenomyosis patients, and the area under the curve was 0.879 (P<0.001). The 5 metabolites included Androsterone, Propionic acid, Glycocholic acid, 2,6-Dihydroxypurine, Deoxycorticosterone. And this study explored the metabolic differences between adenomyosis group and control group.
A "5 metabolites + age" panel could effectively predict pregnancy outcomes of adenomyosis patients who undergoing FET. There were notable differences in plasma metabolic profiles between adenomyosis-associated infertility and control patients.
本研究探讨子宫腺肌病（ADM）不孕患者外周血的代谢谱，以确定影响这些接受冻融胚胎移植（FET）患者妊娠结局的关键代谢物。我们的目标是建立一个基于代谢物的子宫腺肌病相关性不孕妊娠结局临床预测模型。
这项来自北京大学第三医院生殖中心的前瞻性队列研究纳入了94例子宫腺肌病不孕患者和接受FET的对照（CTRL）患者。我们根据临床妊娠成功情况将这些患者分为四组：ADM-成功组、ADM-失败组、CTRL-成功组和CTRL-失败组。我们在胚胎移植当天采集外周血，并使用超高效液相色谱-串联质谱分析代谢物。我们使用生物信息学比较四组之间的代谢组差异，并使用受试者工作特征曲线评估代谢物预测妊娠结局的诊断性能。
我们发现了ADM-成功组和ADM-失败组之间的代谢差异，并建立了一个“5种代谢物+年龄”模型（5种代谢物与女性年龄模型相结合），该模型可以有效预测子宫腺肌病患者的妊娠结局，曲线下面积为0.879（P<0.001）。这5种代谢物包括雄甾酮、丙酸、甘氨胆酸、2,6-二羟基嘌呤、脱氧皮质酮。并且本研究还探讨了子宫腺肌病组与对照组之间的代谢差异。
“5种代谢物+年龄”模型可以有效预测接受FET的子宫腺肌病患者的妊娠结局。子宫腺肌病相关性不孕患者与对照患者的血浆代谢谱存在显著差异。
