FOS and Other Genes Linked to Oxidative Stress Are Upregulated in Women Suffering from Endometriosis and Might Negatively Impact the Oocyte Developmental Competence During ICSI.

We aim to elucidate the impact of endometriomas on oocyte developmental competence and identify genetic alterations that may influence ICSI success rates in women of different ages. In this retrospective study, two groups of patients have been analyzed: 108 women with a history of severe endometriosis (stages III and IV), who underwent OPU and ICSI after endometriosis surgery, and a control group, built out of 108 women with no endometriosis history. The Turku Endometriosis Database was used for differential gene expression analysis. The number of aspirated oocytes (endometrioma group: 2.75 ± 0.32 vs. control 10.32 ± 0.54) was significantly (p < 0.0001) lower in patients with endometrioma excision, and the number of generated blastocysts was significantly (p < 0.0001) lower when compared to patients without endometriosis (endometrioma group: 1.09 ± 0.13 vs. control group: 3.76 ± 0.23). Additionally, AMH levels were significantly lower (p < 0.001) in the endometriosis-affected group below the age of 35 years (1.65 ± 0.15) than in the unaffected control group (2.99 ± 0.27) within the same age group. The mRNA expression of the following genes related to oxidative stress was significantly (p < 0.05) upregulated in the endometriosis group compared with healthy controls: DES, P2RX1, FOS, SRF, RASD2, SLITRK3, and TEAD3. Gene Ontology and pathway enrichment analyses demonstrated a significant (p < 0.0001) enrichment of oxidative stress-associated biological processes and signaling pathways, including responses to reactive oxygen species and hypoxia, HIF-1, MAPK, PI3K-Akt, NF-κB, and apoptotic signaling, supporting oxidative stress as a central molecular mechanism underlying the observed transcriptomic alterations. In conclusion, this retrospective study provides a holistic perspective on the impact of endometrioma and its oxidative stress effect on oocyte developmental rates and ICSI outcomes across different age groups.