Amino acid composition of the endometrium in patients with diminished ovarian reserve
Dubinskaya E.D., Mglinets A.P., Gasparov A.S., Alyoshkina E.V.
Objective. To determine the characteristics of the endometrial amino acid profile in patients with diminished ovarian reserve (DOR) compared with patients with normal ovarian reserve in early and middle reproductive age.
Materials and methods. An observational cross-sectional comparative study was conducted in 110 reproductive-age patients (20–35 years) undergoing preparation for assisted reproductive technology (ART) programs. Patients were divided into two groups: group 1 comprised 80 patients with DOR (AMH<1.2 ng/mL, AFC<5–7 in each ovary); group 2 (control) comprised 30 patients with normal ovarian reserve. Endometrial samples were obtained by pipelle biopsy during the mid-secretory phase of the menstrual cycle. Twenty-three amino acids and their metabolites were analyzed using UPLC-MS/MS). Statistical analyses were performed using the MetaboAnalyst v5.0 platform and included univariate analysis (Mann–Whitney U test, FDR) and multivariate statistical analysis (PCA, PLS-DA), as well as metabolic pathway analysis.
Results. Statistically significant differences were identified for 11 amino acids (q<0.05). Patients with DOR showed marked reductions in sarcosine concentration (7.91-fold; FC=0.13), tryptophan (FC=0.68), pipecolic acid (FC=0.76), and leucine (FC=0.89). At the same time, increased levels of alanine (FC=1.64), γ-aminobutyric acid (FC=1.61), asparagine (FC=1.56), glutamine (FC=1.55), proline (FC=1.44), hydroxyproline (FC=1.17), and aspartic acid (FC=1.15) were observed. Multivariate PLS-DA demonstrated clear separation of the groups based on their metabolic profiles. The most pronounced changes involved the alanine, aspartate and glutamate, and arginine and proline metabolic pathways.
Conclusion. DOR in patients of early and middle reproductive age is associated with the development of a local metabolic phenotype of the endometrium characterized by alterations in amino acid composition. These changes may be associated with the functional state of the endometrium and its implantation potential.
Authors' contributions. Dubinskaya E.D. – conception and design of the study, scientific supervision, editing of the manuscript; Mglinets A.P. – data collection and analysis, statistical analysis, literature review, drafting of the manuscript; Gasparov A.S. – consultation, editing of the manuscript; Alyoshkina E.V. – data processing and drafting of the manuscript.
Conflicts of interest. The authors have no conflicts of interest to declare.
Funding. There was no funding for this study.
Ethical Approval: The study was reviewed and approved by the Research Ethics Committee of the Patrice Lumumba Peoples' Friendship University of Russia (Ref. No: 4).
Generative Artificial Intelligence. No artificial intelligence tools were used in the preparation of this manuscript.
Patient Consent for Publication. All patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement. The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
For citation: Dubinskaya E.D., Mglinets A.P., Gasparov A.S., Alyoshkina E.V. Amino acid composition
of the endometrium in patients with diminished ovarian reserve.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (10): 89-99 (in Russian)
https://dx.doi.org/10.18565/aig.2026.293
Keywords
endometrium
endometrial receptivity
amino acid composition
diminished ovarian reserve
metabolomics
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Received 01.09.2026
Accepted 14.09.2026
About the Authors
Ekaterina D. Dubinskaya, Dr. Med. Sci., Professor at the Department of Obstetrics, Gynecology with a Course in Perinatology, Medical Institute, Patrice Lumumba Peoples’ Friendship University of Russia, 8 Miklukho-Maklaya str., Moscow, 117198, Russia, +7(903)117-55-58, eka-dubinskaya@yandex.ru, https://orcid.org/0000-0002-8311-0381Anna P. Mglinets, PhD Student, Department of Obstetrics, Gynecology with a Course in Perinatology, Medical Institute, Patrice Lumumba Peoples’ Friendship University
of Russia, 8 Miklukho-Maklaya str., Moscow, 117198, Russia, +7(906)056-49-98, mg.anna@mail.ru, https://orcid.org/0009-0001-3985-3954
Alexander S. Gasparov, Dr. Med. Sci., Professor, Professor at the Department of Obstetrics, Gynecology with a Course in Perinatology, Medical Institute, Patrice Lumumba Peoples’ Friendship University of Russia, 8 Miklukho-Maklaya str., Moscow, 117198, Russia, +7(985)776-77-78, 13513520@mail.ru, https://orcid.org/0000-0001-6301-1880
Elizaveta V. Alyoshkina, Teaching Assistant at the Department of Obstetrics, Gynecology with a Course in Perinatology, Medical Institute, Patrice Lumumba Peoples’ Friendship University of Russia, 8 Miklukho-Maklaya str., Moscow, 117198, Russia, +7(926)768-44-27, alyoshkina.ev@yandex.ru, https://orcid.org/0000-0001-5339-1285
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