Why Has Metabolomics So Far Not Managed to Efficiently Contribute to the
Improvement of Assisted Reproduction Outcomes? The Answer through a
Review of the Best Available Current Evidence
Metabolomics emerged to give clinicians the necessary information on the
competence, in terms of physiology and function, of gametes, embryos,
and the endometrium towards a targeted infertility treatment, namely,
assisted reproduction techniques (ART). Our minireview aims to
investigate the current status of the use of metabolomics in assisted
reproduction, the potential flaws in its use, and to propose specific
solutions towards the improvement of ART outcomes through the use of the
intervention. We used published reports assessing the role of
metabolomic investigation of the endometrium, oocytes, and embryos in
improving clinical outcomes in women undergoing ART. We initially found
that there is no evidence to support that fertility outcomes can be
improved through metabolomics profiling. In contrast, it may be helpful
for understanding and appraising the nutritional environment of oocytes
and embryos. The causes include the different infertility populations,
the difference between animals and humans, technical limitations, and
the great heterogeneity in the variables employed. Suggested steps
include the standardization of variables of the method itself, the
universal creation of a panel where all biomarkers are stored concerning
specific infertile populations with different phenotypes or etiologies,
specific bioinformatics contribution, significant computing power for
data processing, and importantly, properly conducted trials