Oxidative stress and female infertility: the role of follicular fluid soluble receptor of advanced glycation end-products (sRAGE) in women with endometriosis

Higher oxidative balance score is associated with lower female infertility: a cross-sectional study

Background

An imbalance of the pro-oxidant and antioxidant profiles in the body contributes to the development of diseases, including female infertility.

Methods

In this study, we performed a secondary analysis of the National Health and Nutrition Examination Survey and calculated the values of oxidative balance score (OBS). A weighted logistic regression model was used to explore the potential relationship between OBS (continuous factor and quartile set) and female infertility, and the P for trend was calculated. Subgroup analyses were also carried out further to explore the association between OBS and female infertility, and the P for interactions were obtained.

Results

There were 1,626 females (aged 18 to 45) included in the study, including 198 with infertility and a prevalence of approximately 13.28%. Multifactorial logistic regression showed a 5% decrease in infertility for each unit increased in OBS (OR, 0.95; 95% CI, 0.92 to 0.98). When OBS was used as a categorical variable, female infertility decreased by 60% in the highest OBS group compared with the lowest OBS group (OR, 0.40; 95% CI, 0.21 to 0.74). In addition, subgroup analyses showed that the negative association between OBS and infertility was significant in the non-chronic disease (hypertension and diabetes) population, those with less than a high school educational background, poverty-to-income ratio (1 to 3), and those with more than 30 years of age.

Conclusion

Higher OBS was negatively associated with female infertility. Further prospective studies are needed to determine causality and to provide new perspectives on female infertility in the context of diet and lifestyle.

Oxidative Imbalance in Endometriosis-Related Infertility-The Therapeutic Role of Antioxidants

Endometriosis in half of affected women is closely related to problems with fertility. Endometriosis-associated infertility is caused by a wide range of abnormalities affecting the female reproductive tract, from oocyte quality impairment to disturbances in the eutopic endometrium or mechanical abnormalities resulting from disease progression. Since supportive antioxidant therapies, in addition to surgical treatment or assisted reproductive techniques (ARTs), have overall been proven to be effective tools in endometriosis management, the objective of our review was to analyze the role of antioxidant substances, including vitamins, micronutrients, N-acetylcysteine (NAC), curcumin, melatonin, and resveratrol, in endometriosis-related infertility. Most of these substances have been proven to alleviate the systemic oxidant predominance, which has been expressed through decreased oxidative stress (OS) markers and enhanced antioxidative defense. In addition, we demonstrated that the predominant effect of the aforementioned substances is the inhibition of the development of endometriotic lesions as well as the suppression of pro-inflammatory molecules. Although we can undoubtedly conclude that antioxidants are beneficial in fertility support, further studies explaining the detailed pathways of their action are needed.