Summary
Objective. To analyze the scientific literature on the role of oxidative stress in female unexplained infertility, to discuss the main oxidative stress biomarkers relevant to infertility, and to evaluate potential methods for correcting elevated oxidative stress.
Materials and Methods. A literature search was conducted in PubMed, Science Direct, and Google Scholar databases. Keywords used: infertility, unexplained infertility, infertility of unknown origin, oxidative stress, reactive oxygen species, oxidative stress biomarkers. Articles published between 2015 and 2025, along with selected historically significant sources, were included. Studies were selected based on their relevance and suitability to the topic, focusing on the role of oxidative stress in the pathogenesis of infertility, related biomarkers, and possibilities for correcting elevated oxidative stress.
Literature Review. Oxidative stress plays an important role in several reproductive processes: follicle maturation, ovulation, oocyte development and quality, embryo implantation, and pregnancy maintenance. The most commonly investigated oxidative stress biomarkers include total antioxidant capacity (TAC), malondialdehyde (MDA), superoxide dismutase (SOD), glutathione (GSH), ceruloplasmin (Cp), and the myeloperoxidase- to-paraoxonase ratio (MPO/PON). Evidence shows that unexplained infertility is frequently associated with an imbalance between oxidative stress and the antioxidant defense system, resulting in elevated oxidative stress levels. In this condition, TAC, SOD, and GSH concentrations are often reduced, while MDA and the MPO/PON ratio are increased. Antioxidant supplementation, lifestyle modifications, and novel pharmacological therapies may help reduce oxidative stress levels in infertile women and improve reproductive outcomes.
Conclusions. Elevated oxidative stress is a significant factor that may contribute to the development of unexplained female infertility. Current evidence suggests that strengthening the antioxidant system through lifestyle changes, dietary interventions, and targeted therapy can improve reproductive outcomes and increase the success rates of assisted reproductive technologies.
