Oxidative Stress and Cellular Death Biomarkers Assessment in Follicular Fluid of Patients with Endometriosis Undergoing IVF/ICSI Treatment

Author(s): Albane Vandecandelaere, Guillaume Jedraszak, Dorian Bosquet, Sophian Tricotteaux, Florence Scheffler, Antoine Galmiche, Arthur Foulon, Moncef Benkhalifa, Rosalie Cabry

To date, the pathogenesis of endometriosis related infertility is still poorly understood. In particular, impaired oocyte quality, parameter that remains difficult to assess in current practice could be implicated in this infertility. The objective of this study was to assess oocyte quality indirectly via an oxidative stress biomarker (8-hydroxy-2-deoxyguanosine, 8OHdG) and cell death marker (cell free DNA) in mature follicular fluid of patients with endometriosis undergoing IVF/ICSI treatment. Follicular fluid from a mature follicle was analyzed for 32 patients with and 35 without endometriosis. Patients were enrolled between July 2020 and February 2023 in university hospital of Amiens. Obese patients, with poor ovarian reserve or with PCOS were excluded. 8OHdG was determined by immunohistochemistry and cell free DNA by ALU-qPCR. Cell free DNA was also performed on serum of patients before and during stimulation. These analyses were then correlated to the results of IVF outcomes. Concentration of follicular 8OHdG and cell free DNA were not different depending on the presence of endometriosis or on the presence of endometrioma. There was also no significant difference in the results of IVF treatment and embryo development depending on the presence of endometriosis. However, on the whole cohort, follicular cell free DNA was negatively correlated to oocyte maturity and follicular 8OHdG negatively correlated to fertilization rate and number of good quality embryo. We cannot claim about poor oocyte quality in endometriosis with this assay. However, it revealed follicular 8OHdG and cell free DNA as potential prognostic biomarkers for IVF/ICSI outcomes.