The lipidome of endometrial fluid differs between implantative and non-implantative IVF cycles

Objective To characterize the most relevant changes in the lipidome of endometrial fluid aspirate (EFA) in non-implantative cycles. Design Lipidomics in a prospective cohort study. Settings Reproductive unit of a university hospital. Patients Twenty-nine women undergoing an IVF cycle. Fifteen achieved pregnancy and 14 did not. Intervention Endometrial fluid aspiration immediately before performing embryo transfer. Main outcome measures Clinical pregnancy rate and lipidomic profiles obtained on an ultra-high performance liquid chromatography coupled to time-of-flight mass spectrometry (UHPLC-ToF-MS)-based analytical platform. Results The comparative analysis of the lipidomic patterns of endometrial fluid in implantative and non-implantative IVF cycles revealed eight altered metabolites: seven glycerophospholipids and an omega-6 polyunsaturated fatty acid. Then, women with a non-implantative cycle were accurately classified with a support vector machine algorithm including these eight lipid metabolites. The diagnostic performances of the algorithm showed an area under the receiver operating characteristic curve, sensitivity, specificity, and accuracy of 0.893 ± 0.07, 85.7%, 80.0%, and 82.8%, respectively. Conclusion A predictive lipidomic signature linked to the implantative status of the endometrial fluid has been found.