Metabolic profiling of a polycystic ovary syndrome-like organoid model reveals the critical role of glutamine in local endometrial dysregulation related to implantation failure.

Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder characterized by reproductive and metabolic disturbances, which causes a chronic lack of ovulation that leads to increased incidence of atypical endometrial hyperplasia and carcinogenesis. Increasing evidence indicates that metabolic changes may play a crucial role in PCOS pathogenesis; however, the metabolic profile of fluid in PCOS-related endometrium has not yet been characterized. In this study, we successfully constructed three cases of endometrial organoids derived from clinically healthy endometrium. We established a high-androgen model by adding different ratios of estradiol and testosterone to simulate PCOS-like characteristics. Through scanning electron microscopy and immunofluorescence detection, we found that extra androgen treatment-induced cellular damage led to cellular fragments and apoptosis. The intra-organoid fluid (IOF) and extra-organoid fluid (EOF) of the organoids were separated and analyzed by high-throughput quantitative metabolomics. The results showed that amino acid metabolism, specifically glutamine metabolic changes, was the major metabolic pathway altered in the EOF; meanwhile, changes in fatty acids were the main metabolites in the IOF among the groups. Specifically, the