Serum bile acid metabolic profiles in polycystic ovary syndrome: insights from targeted metabolomics and correlation with embryonic parameters

Objective Polycystic ovary syndrome (PCOS) is a complex endocrine disorder. In this study, we characterize serum bile acids (BAs) metabolic profiles in PCOS patients using targeted metabolomics and investigated their correlation with embryonic parameters, thereby elucidating the role of BAs in the pathogenesis of PCOS. Methods We enrolled 20 PCOS patients undergoing in vitro fertilization-embryo transfer (IVF-ET) who met the Rotterdam criteria and 20 age-matched healthy controls. We recorded clinical baseline data and collected serum samples from all participants. The metabolic profiles of BAs were obtained by performing ultra-high-performance liquid chromatography–tandem mass spectrometry (UHPLC–MS/MS). Orthogonal partial least squares discriminant analysis (OPLS-DA) and receiver operating characteristic (ROC) curve analyses were performed to identify differential metabolites and evaluate their diagnostic value. Finally, we further analyzed the correlations between key differential metabolites and clinical indicators. Results We identified 43 BA metabolites, including 22 upregulated and 21 downregulated species. We selected 11 key BA metabolites, of which six demonstrated diagnostic potential based on ROC curve analysis. We found negative correlations between these metabolites and embryonic parameters, although none of the correlations were statistically significant. Conclusion Although targeted metabolomics is an exploratory tool, it is valuable for identifying potential diagnostic biomarkers in PCOS, offering preliminary novel insights into the pathophysiology of PCOS. The findings of this study suggest that targeted modulation of the metabolism of BA may represent an emerging and promising strategy for ameliorating metabolic and reproductive dysfunction in PCOS; however, these findings need to be validated in larger, independent cohorts.