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

J Assist Reprod Genet. 2020 Feb;37(2):385-394. doi: 10.1007/s10815-019-01670-z. Epub 2019 Dec 21.


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.

Keywords: Assisted reproduction; Endometrial fluid; Implantation; In vitro fertilization; Lipidomics; Machine learning algorithms; Pregnancy.

MeSH terms

  • Adult
  • Embryo Implantation / genetics*
  • Embryo Transfer
  • Endometrium / chemistry*
  • Female
  • Fertilization in Vitro / methods
  • Humans
  • Infertility, Female / genetics*
  • Infertility, Female / metabolism
  • Lipidomics / methods
  • Lipids / chemistry
  • Lipids / genetics*
  • Pregnancy
  • Pregnancy Rate
  • ROC Curve


  • Lipids