Background: Ovarian cancer (OC) is a common gynecological malignant tumor with poor prognosis.Ferroptosis is an iron-dependent modality of regulated cell death. The purpose of this study was to determine the prognostic ability of ferroptosis-related long non-coding RNAs (lncRNAs) in OC patients and construct a ferroptosis-related lncRNA prognostic model. Methods: The Cancer Genome Atlas (TCGA) and FerrDb databases were used to collect RNA sequencing data of OC patients and ferroptosis-related genes, respectively. OC patients were randomly assigned to the training or testing set. Pearson correlation analysis was used to identify ferroptosis-related lncRNAs. Univariate Cox, Least Absolute Shrinkage and Selection Operator (LASSO), and multivariate regression analyses were performed in the training set to develop a predictive model. The model was validated in the testing set and entire set. Survival analysis, receiver operating characteristic curves, independent prognostic factor analysis, and correlation analysis with clinical features were performed to evaluate the predictive value of the model. A nomogram was established to predict the survivability of OC patients over 1, 3, and 5 years. The distribution of distinct groups was investigated using principal component analysis, and the underlying the biological functions were explored using gene set enrichment analysis. Results: Eleven ferroptosis-related lncRNAs were determined to establish the prognostic model. Patients in the high-risk group had poor prognosis compared with the low-risk group in the training, testing and entire sets. The area under the receiver operating characteristic curve corresponding to 1-, 3-, and 5-year survival were 0.731, 0.796, and 0.805 in the training set; 0.704, 0.597, and 0.655 in the testing set; and 0.715, 0.691, and 0.736, in the entire set, respectively. The risk score correlated with age and grade. The risk score was also an independent prognostic factor in OC. A nomogram with high C-index (0.68) was constructed. An intuitive observation of the principal component analysis revealed a distinction between high-and lowrisk groups, and gene set enrichment analysis indicated that cancer-related pathways were enriched in the high-risk group. Conclusions: The signature composed of 11 ferroptosis-related lncRNAs accurately predicted the prognosis of OC patients.

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Summary To explore whether embryo culture with melatonin (MT) can improve the embryonic development and clinical outcome of patients with repeated cycles after in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) failure, immature oocytes from controlled ovarian superovulation cycles were collected for in vitro maturation (IVM) and ICSI. The obtained embryos were cultured in 0, 10–11, 10–9, 10–7 and 10–5 M MT medium respectively, and 10–9 M was screened out as the optimal concentration. Subsequently, 140 patients who underwent failed IVF/ICSI cycles received 140 cycles of embryo culture in vitro with a medium containing 10–9 M MT, these 140 MT culture cycles were designated as the experimental group (10–9 M group), and the control group was the previous failed cycles of patients (0 M group). The results showed that the fertilization, cleavage, high-quality embryo, blastocyst, and high-quality blastocyst rates of the 10–9 M group were significantly higher than those of the 0 M group (P < 0.01; P < 0.01; P < 0.0001; P < 0.0001; P < 0.0001). To date, in total, 50 vitrified-warmed cycle transfers have been performed in the 10–9 M group and the implantation rate, biochemical pregnancy rate and clinical pregnancy rate were significantly higher than those in the 0 M group (all P < 0.0001). Two healthy infants were delivered successfully and the other 18 women who achieved clinical pregnancy also had good examination indexes. Therefore the application of 10–9 M MT to embryo cultures in vitro improved embryonic development in patients with repeated cycles after failed IVF/ICSI cycles and had good clinical outcomes. Trial registration: ChiCTR2100045552.