Microbiome analysis of the cystic fluid in ovarian endometrioma: new avenues for the prevention, diagnosis, and treatment of the disease.

OBJECTIVE

This study aimed to investigate the microbiome profile in the cystic fluid of ovarian endometrioma and explore its association with the microbial communities present in the lower and upper reproductive tracts.

DESIGN

A microbial analysis was conducted across multiple compartments of the reproductive tract in patients diagnosed with ovarian endometrioma.

SUBJECTS: Sixteen female patients aged 25-43 years (mean age: 31.56 years) who underwent laparoscopic surgery for ovarian endometrioma at the First Hospital of Putian City between April 2023 and February 2024 were enrolled in this study.

MAIN OUTCOME MEASURES: 16S rDNA sequencing was employed to characterize the microbiome of ovarian endometrioma and assess its correlations with clinical symptoms, inflammatory markers, and serum CA125 levels

RESULTS

Microbial communities were detected in the posterior vaginal fornix, endometrial fluid, peritoneal fluid, and cystic fluid, exhibiting distinct compositional profiles. Community diversity significantly increased along the anatomical gradient from the posterior vaginal fornix to endometrial fluid, peritoneal fluid, and cystic fluid, with the highest microbial diversity observed in the cystic fluid. Lactobacillus was the predominant genus in the posterior vaginal fornix, whereas Escherichia-Shigella was most abundant in endometrial fluid samples. Hydrogenophaga and Brevundimonas were the dominant taxa in both peritoneal and cystic fluids. Notably, the microbial composition of peritoneal fluid showed the greatest similarity to that of cystic fluid, and functional prediction analyses indicated largely overlapping biological functions between these two sites. Furthermore, Spearman correlation analysis revealed significant associations between specific microbial taxa and certain clinical manifestations or inflammatory factors.

CONCLUSION

This study demonstrates the presence of a unique and highly diverse microbiome within the cystic fluid of ovarian endometrioma. The site-specific microbial profiles and their correlations with clinical parameters suggest a potential role of microbiota in disease pathogenesis through inflammatory and metabolic mechanisms. These findings contribute novel insights that may inform future strategies for the prevention, diagnosis, and treatment of ovarian endometrioma.