Oxidative Stress and its Role in Female Infertility and Assisted Reproduction: Clinical Implications

Abstract

Reactive oxygen species (ROS) are involved in physiological functions and act as mediators invarious signaling processes. Elevated or sustained generation of free radicals and non radicalspecies derived from free radicals can lead to an imbalance in the intracellular redox homeostasis.Normally, any excess levels of reactive radical and nonradical species generated are interceptedby antioxidants. An excess of the free radicals however, can precipitate pathologies in thefemale reproductive tract. Oxidative stress (OS) is involved in various pathological conditionssuch as abortions, preeclampsia, hydatidiform mole, fetal teratogenecity, preterm labor andintrauterine growth retardation, all of which lead to an immense burden of maternal and fetal,morbidity and mortality. In addition evidence suggests that oxidative stress plays a role in theproinflammatory changes seen with polycystic ovarian disease and also in the pathogenesisof endometriosis and tubal factor infertility. Our review captures the role of OS in assistedreproduction specifically in in vitro fertilization (IVF)/ intracytoplasmic sperm injection(ICSI) and in vitro maturation of oocytes (IVM). We also examine the role antioxidants playin modifying the fertility outcomes with assisted reproductive techniques. Finally in vivo andin vitro strategies to modulate the influence of ROS and establish an optimal redox state arealso discussed.