Objective To investigate the effect of differential microRNA(miRNA)derived from follicular fluid exosomes on oocyte quality in patients with endometriosis(EMT).Methods Follicular fluid was collected from 20 infertile patients undergoing IVF-ET/ICSI in the Reproductive Medicine Center of Guangzhou First People's Hospital from December 2021 to March 2022,including EMT group(10 patients with EMT infertility)and control group(10 patients with simple male factor infertility).The miRNA spectrum in follicular fluid exosomes was analyzed by high-throughput sequencing and miRNAs with differences between groups were selected.Results Compared with patients with infertility due to simple male factors,there were significant differences in 18 exosomal miRNAs in the EMT group,of which 9 were up-regulated and 9 were down-regulated.GO and KEGG enrichment analysis showed that these target genes were mainly involved in phosphatidylinositol-3-kinase/protein kinase B,Nucleotide binding oligomerization domain-like receptor and other signaling pathways.Conclusions There are differences in follicular fluid-derived exosomal miRNAs in EMT patients.Differential exosomal miRNAs may affect oocyte quality in EMT patients through multiple signaling pathways.