Abstract:Objective To explore biomarkers related to poor ovarian response based on follicular fluid metabolomics. Methods In vitro fertilization-embro transfer/intracy to plasmic sperm injection-embro transfer (IVF-ET/ICSI-ET) was performed by ultra-high liquid chromatography-high resolution mass spectrometry. 30 patients in the ovarian low-response group and 49 patients in the control group who received IVF-ET/ICSI-ET only due to male factors were analyzed for follicular fluid metabolomics, and the differential metabolites of the two groups were compared. Results This study found 30 potential biomarkers associated with low ovarian response. Upregulated metabolites included L-phenylalanine, proline, tryptophan, 1-hydroxy-2-oxypropyl tetrahydropterin, magnesium salicylate, uridine 5'-diphosphate, LysoPC (18 : 3), LysoPC (18 : 2) and LysoPC (18 : 1). Downregulated metabolites included 6-oxohexanoate, linoleate, oleic acid, hexadecanal, arachidonate, DHA, 13, 14-dihydroretinol, lithocholate, 7-dehydrodesmosterol, stearoylcarnitine, 25-hydroxyvitamin-D3, 27-hydroxycholestero and 3 alpha, 7 alpha and 12 alpha-Trihydroxy-5beta-cholestan-26-al, 13'-hydroxy-alpha-tocopherol, dynorphinA, LysoPC (16 : 1), LysoPC (16 : 0), LysoPC (18 : 0), LysoPC (20 : 5), LysoPC (20 : 4) and LysoPC (20 : 3). Conclusions Ovarian reserve, ovarian response, egg number and quality of patients with low ovarian response decrease compared with normal females; the follicular fluid metabolites of patients with low ovarian response were different from those of normal women, and the difference was statistically significant (P?0.05). These differential metabolites could be used as biomarkers for low ovarian response.