ObjectiveTo investigate the impact of follicular fluid (FF) proteomic composition vs AMH levels as biomarkers of oocyte quality and embryo implantation potential.Design270 patients included into a two-arms randomized open-lable prospective study. A fixed antagonist protocol + αr-FSH stimulation was used. r-hCG was used to trigger ovulation.Materials and MethodsInclusion criteria: FSH d3 ≤10 IU/mL, BMI >20 and < 27 kg/m2, Age <38.Exclusion criteria: PCOS, endometriosis, endocrine, genetic, systemic inflammatory-immunological disorders.135 patients with N°3 Follicles with FF AMH level ≥4,0 ng/ml. 135 patients with N°3 Follicles with FF AMH level ≤1,0 ng/ml. Proteomic analyses were carried out by 2D isoelectric focusing by the direct sample rehydratation method followed by Sypro Ruby staining and comparison with PDQuest software. Non parametric comparison, χ2, Mann-Whitney test were used. Logistic regression was used to calculate the likelihood of live birth in relation to the protein spot of interest.Results15 potential FF protein were identified: αHaptoglobin, mitochondrial integrity genome, apolipoprotein H, transferrin, lyzozymeC,αfibrinogen,immunoglobulin heavy chain V-III were increased in the live birth group,whereas γand β chains fibrinogen, antithrombin, vitamin D-binding protein, and complement 3 and 4 were decreased. Serological and FF AMH levels influence FF soluble proteome. In the high FF AMH levels 84% were down-regulated (transferrin, immunoglobulin light chain, albumin,CO4 complement) and 16% up-regulated (immunoglobulin unknown chain, clusterin,α-1-antitrypsin,α-2-HS-glycoprotein,antithrombin,β-fibrinogen,apolipoprotein A2.Haptoglobin was either down- or up-regulated.Conclusion2D protein mapping allowed identification of several proteins that may play a role in follicle physiology and ovarian activity. Proteomic evaluation of follicular fluid is able to identify potential biomarkers of good versus poor prognosys patients. AMH levels influence oocyte quality and embryo implantation potential. ObjectiveTo investigate the impact of follicular fluid (FF) proteomic composition vs AMH levels as biomarkers of oocyte quality and embryo implantation potential. To investigate the impact of follicular fluid (FF) proteomic composition vs AMH levels as biomarkers of oocyte quality and embryo implantation potential. Design270 patients included into a two-arms randomized open-lable prospective study. A fixed antagonist protocol + αr-FSH stimulation was used. r-hCG was used to trigger ovulation. 270 patients included into a two-arms randomized open-lable prospective study. A fixed antagonist protocol + αr-FSH stimulation was used. r-hCG was used to trigger ovulation. Materials and MethodsInclusion criteria: FSH d3 ≤10 IU/mL, BMI >20 and < 27 kg/m2, Age <38.Exclusion criteria: PCOS, endometriosis, endocrine, genetic, systemic inflammatory-immunological disorders.135 patients with N°3 Follicles with FF AMH level ≥4,0 ng/ml. 135 patients with N°3 Follicles with FF AMH level ≤1,0 ng/ml. Proteomic analyses were carried out by 2D isoelectric focusing by the direct sample rehydratation method followed by Sypro Ruby staining and comparison with PDQuest software. Non parametric comparison, χ2, Mann-Whitney test were used. Logistic regression was used to calculate the likelihood of live birth in relation to the protein spot of interest. Inclusion criteria: FSH d3 ≤10 IU/mL, BMI >20 and < 27 kg/m2, Age <38. Exclusion criteria: PCOS, endometriosis, endocrine, genetic, systemic inflammatory-immunological disorders. 135 patients with N°3 Follicles with FF AMH level ≥4,0 ng/ml. 135 patients with N°3 Follicles with FF AMH level ≤1,0 ng/ml. Proteomic analyses were carried out by 2D isoelectric focusing by the direct sample rehydratation method followed by Sypro Ruby staining and comparison with PDQuest software. Non parametric comparison, χ2, Mann-Whitney test were used. Logistic regression was used to calculate the likelihood of live birth in relation to the protein spot of interest. Results15 potential FF protein were identified: αHaptoglobin, mitochondrial integrity genome, apolipoprotein H, transferrin, lyzozymeC,αfibrinogen,immunoglobulin heavy chain V-III were increased in the live birth group,whereas γand β chains fibrinogen, antithrombin, vitamin D-binding protein, and complement 3 and 4 were decreased. Serological and FF AMH levels influence FF soluble proteome. In the high FF AMH levels 84% were down-regulated (transferrin, immunoglobulin light chain, albumin,CO4 complement) and 16% up-regulated (immunoglobulin unknown chain, clusterin,α-1-antitrypsin,α-2-HS-glycoprotein,antithrombin,β-fibrinogen,apolipoprotein A2.Haptoglobin was either down- or up-regulated. 15 potential FF protein were identified: αHaptoglobin, mitochondrial integrity genome, apolipoprotein H, transferrin, lyzozymeC,αfibrinogen,immunoglobulin heavy chain V-III were increased in the live birth group,whereas γand β chains fibrinogen, antithrombin, vitamin D-binding protein, and complement 3 and 4 were decreased. Serological and FF AMH levels influence FF soluble proteome. In the high FF AMH levels 84% were down-regulated (transferrin, immunoglobulin light chain, albumin,CO4 complement) and 16% up-regulated (immunoglobulin unknown chain, clusterin,α-1-antitrypsin,α-2-HS-glycoprotein,antithrombin,β-fibrinogen,apolipoprotein A2.Haptoglobin was either down- or up-regulated. Conclusion2D protein mapping allowed identification of several proteins that may play a role in follicle physiology and ovarian activity. Proteomic evaluation of follicular fluid is able to identify potential biomarkers of good versus poor prognosys patients. AMH levels influence oocyte quality and embryo implantation potential. 2D protein mapping allowed identification of several proteins that may play a role in follicle physiology and ovarian activity. Proteomic evaluation of follicular fluid is able to identify potential biomarkers of good versus poor prognosys patients. AMH levels influence oocyte quality and embryo implantation potential.