Dietary Antioxidants, Oxidative Stress, and Women’s Reproductive Health

Unexplained infertility (UI) continues to pose a diagnostic challenge, affecting a considerable proportion of reproductive-aged women. Increasing evidence suggests that oxidative stress (OS) may contribute to impaired female reproductive function. Malondialdehyde (MDA) is a lipid peroxidation marker, while total antioxidant capacity (T-AOC) reflects overall antioxidant defense. Evaluating these biomarkers may help to better understand the role of OS in UI and the potential benefit of antioxidant therapy. A prospective observational study included 30 women diagnosed with primary unexplained infertility. Serum levels of MDA and T-AOC were measured at baseline and after a period of antioxidant supplementation lasting 1–7 months (duration mode: 3 months). All participants received standardized antioxidant therapy consisting of vitamin E (50 mg/day), zinc (15 mg/day), coenzyme Q10 (15 mg/day), and selenium (70 µg/day). Participants with known causes of infertility were excluded. Nonparametric statistical tests were used to evaluate changes in oxidative stress markers before and after supplementation and to compare subgroups with and without comorbidities. Median baseline MDA concentration was 228.2 ng/mL and decreased significantly after antioxidant supplementation to 173.9 ng/mL (p < 0.001), with a reduction observed in 90% of participants. Median T-AOC increased slightly from 23.9 U/mL to 26.2 U/mL, but the change was not statistically significant (p = 0.735). No significant differences in oxidative stress markers were found between women with and without comorbidities, although higher baseline MDA levels were observed in participants with endometriosis (stage I–II). A significant decrease in MDA after supplementation was seen both in women with endometriosis (p = 0.005) and without it (p < 0.001). Women with unexplained infertility demonstrate biochemical evidence of oxidative stress, reflected by elevated MDA levels. Antioxidant supplementation was associated with a significant reduction in lipid peroxidation, suggesting a potential therapeutic role of antioxidants in UI. Combined assessment of MDA and T-AOC may provide useful insight into oxidative imbalance in infertility, although larger controlled studies are needed. Full article

Oxidative stress appears to be implicated in both the initiation and progression of autoimmune thyroiditis. Selenomethionine, which exhibits antioxidant properties, has been shown to reduce thyroid antibody titers in patients with autoimmune thyroiditis. Recent evidence suggests that vitamin E, a fat-soluble antioxidant, may protect against the development of autoimmune thyroiditis, and that its supplementation has been associated with improvements in female sexual function. The objective of the present pilot study was to determine whether vitamin E intake modulates the effects of selenomethionine on female sexual function and depressive symptoms in individuals with thyroid autoimmunity. The study enrolled three groups of reproductive-age women with euthyroid autoimmune thyroiditis, with 26 participants in each group. The groups were matched for age, thyroid peroxidase antibody titers, and TSH levels and differed according to vitamin E intake: adequate intake (group A), low intake (group B), and high intake (group C). All participants received selenomethionine supplementation (200 µg/day) for six months. Antibody titers and hormone levels were measured, and participants completed questionnaires assessing female sexual function (FSFI) and depressive symptoms (BDI-II). At baseline, no differences in biochemical outcomes were observed between the groups, except for testosterone levels. The study groups differed in sexual desire and arousal domain scores, which were higher in group A than in the other two groups. Total FSFI scores, the remaining FSFI domain scores, and BDI-II scores did not differ between groups at baseline. Across all groups, selenomethionine reduced thyroid peroxidase and thyroglobulin antibody titers and increased SPINA-GD and the ratio of free triiodothyronine to free thyroxine; however, the effects on antibody titers were most pronounced in group A. An increase in SPINA-GT and testosterone levels following selenomethionine supplementation was observed only in group A. In this group, selenomethionine also led to significant improvements in total FSFI scores and all individual domain scores. In contrast, in the remaining groups, the effects of supplementation were limited to increases in domain scores for lubrication, sexual satisfaction, and pain. A treatment-related reduction in total BDI-II scores was observed exclusively in women with adequate vitamin E intake. These findings suggest, for the first time, that dietary intake of a natural antioxidant may influence the effects of exogenous selenomethionine on sexual function and depressive symptoms in reproductive-age women with euthyroid autoimmune thyroiditis. Full article

We evaluated the interplay between systemic total antioxidant capacity (TAC), oxidative stress (OS) (lipid hydroperoxides), inflammation, iron status, and oral contraception (OC) use in 182 healthy 23-year-old women (76 OC-users, and 106 non-OC-users). In all women, blood TAC (FORD units) values were significantly inversely associated with OS (FORT units), high-sensitivity C-reactive protein (hsCRP), and transferrin; and positively associated with transferrin saturation (TfS%). No significant associations were observed for hemoglobin, hematocrit, red blood cells, serum iron, soluble transferrin receptor (sTfR), sTfR/log(ferritin) ratio (sTfR-F index), ferritin, folate, uric acid, or creatinine. OS hydroperoxides were positively associated with hsCRP and transferrin, and inversely associated with TfS%. sTfR was positively correlated with hydroperoxides in non-OC-users and with folate in all women and non-OC-users, but was not associated with hsCRP in any group. The combined abnormal condition of low TAC and elevated OS (n = 71) was significantly more frequent among OC-users (OR = 39.0), women with hsCRP ≥ 3 mg L⁻¹ (OR = 10.1), transferrin ≥ 330 mg dL⁻¹ (OR = 6.58), and smokers (OR = 3.76). OC use modulated the TAC/OS balance and inflammation. Low TAC and elevated OS may impact health status. Enhanced TAC/OS knowledge may increase awareness of effects of OC use among fertile-age women. Ferritin was independent of TAC/OS status and OC use, supporting its reliability as an iron biomarker. Full article

Background: Recurrent vulvovaginal candidiasis (RVVC) is a chronic inflammatory disease primarily caused by Candida albicans (C. albicans). Its pathogenesis remains incompletely understood, and clinical management is challenged by recurrence and drug resistance. Ferroptosis, an iron-dependent form of programmed cell death driven by lipid peroxidation, has been implicated in various infectious and inflammatory diseases. However, its role in RVVC remains unclear, with a particular lack of evidence from clinical samples and animal experiments. Objective: This study aimed to investigate the association between RVVC and ferroptosis. First, we analyzed high-throughput sequencing data from human RVVC samples in the Gene Expression Omnibus (GEO) database to identify the expression profile of ferroptosis-related genes. Second, using an established murine model of chronic vulvovaginal candidiasis (CVVC), we validated changes in ferroptosis-related markers in vaginal tissues in vivo. Furthermore, an in vitro model of C. albicans-infected bone marrow-derived macrophages (BMDMs) was employed to explore the underlying mechanisms. This study provides experimental evidence for elucidating the pathogenesis of RVVC and exploring novel therapeutic strategies. Methods: The RVVC-related gene expression dataset GSE278036 was obtained from the GEO database. Differentially expressed genes (DEGs) were screened using the DESeq2 algorithm and intersected with ferroptosis-related genes from the FerrDb database to identify key targets. A protein–protein interaction (PPI) network was constructed using the STRING database and Cytoscape software, and hub genes were identified via the Betweenness centrality algorithm. Functional and pathway analyses, including gene set enrichment analysis (GSEA), Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and WikiPathways, were performed. Immune infiltration analysis characterized the immune microenvironment in RVVC patients. A CVVC mouse model was established in vivo, and a C. albicans-BMDMs infection model was established in vitro. The ferroptosis inhibitor ferrostatin-1 (Fer-1) was administered to investigate the pathological function and regulatory mechanisms of ferroptosis in RVVC at the molecular, cellular, and tissue levels. Results: Differential analysis identified 3132 DEGs in RVVC, which intersected with ferroptosis-related genes to yield 194 key targets. Among them, 20 hub genes were identified, including ferroptosis regulators and inflammatory factors. Functional enrichment analysis confirmed that these shared targets regulate RVVC pathology through a “ferroptosis-inflammation-immunity” multi-pathway network. Immune infiltration analysis revealed a specific immune disorder in RVVC patients characterized by “activation of the pro-inflammatory innate immune axis and suppression of the adaptive immune axis,” which was closely associated with ferroptosis-related genes. In vivo and in vitro experiments confirmed that C. albicans infection induced ferroptosis in vaginal tissues and macrophages, as manifested by lipid ROS accumulation, Fe²⁺ overload, GSH depletion, downregulation of GPX4 and SLC7A11, upregulation of ACSL4, 4-HNE, and MDA, and mitochondrial structural damage. Macrophages were identified as key target cells for ferroptosis, and their ferroptosis led to impaired antifungal function. Fer-1 treatment significantly inhibited ferroptosis, reduced vaginal histopathological damage and inflammatory cell infiltration, decreased fungal burden, downregulated abnormally elevated inflammatory factors, and restored Th1/Th2 immune balance. Furthermore, Fer-1 preserved macrophage viability and enhanced their antifungal killing capacity. Conclusions: This study provides the first evidence linking RVVC to ferroptosis through a combination of clinical data analysis and experiments, suggesting that ferroptosis is involved in its pathological process. These findings offer a new perspective for elucidating RVVC pathogenesis and developing targeted therapeutic strategies. Full article

Chemotherapy causes primordial follicle apoptosis, resulting in premature ovarian insufficiency (POI) and infertility. In this study, we found that intraperitoneal injection of retinoic acid (RA) and calcitriol partially reversed the cyclophosphamide and doxorubicin treatment-induced decrease in primordial follicles in neonatal mouse ovaries. Furthermore, RA and calcitriol co-treatment reversed cyclophosphamide treatment-induced PI3K/Akt activity and FOXO3a nuclear export in the oocytes within primordial follicles, suggesting that the oocyte transcriptional activity was decreased, which in turn reduced the binding of chemotherapeutic drugs to DNA. Consistent with these findings, RA and calcitriol co-treatment reversed cyclophosphamide treatment-induced changes in reactive oxygen species (ROS), DNA damage response proteins (γH2AX, p-CHK2, p-p53, PUMA, BAX, Cleaved Caspase-3, and cPARP), and antioxidant proteins (NRF2, HO-1, and GPX4). Moreover, RA and calcitriol co-treatment preserved fertility in cyclophosphamide-treated mice without impairing cyclophosphamide’s antitumor efficacy in MCF-7 tumor-bearing mice. Thus, RA and calcitriol protect mouse primordial follicles from cyclophosphamide treatment-induced apoptosis by inhibiting cyclophosphamide treatment-induced oocyte transcriptional activity and enhancing antioxidant capacity. Our results suggest a potential strategy for preserving ovarian reserve during chemotherapy in female cancer patients. Full article

Proto-oncogenic receptor tyrosine kinase (KIT) ligand (KITL) secreted by granulosa cells and its receptor KIT on oocytes are crucial for primordial follicle formation and activation, and follicular development. In the present study, ZnSO₄ decreased the number of primordial and growing follicles in cultured neonatal mouse ovaries when KITL-KIT signaling was inhibited by ISCK03. ZnSO₄ also significantly increased the mRNA and protein levels of Zrt/Irt-like protein 6 (ZIP6, a zinc importer) and zinc levels in the oocytes of cultured neonatal mouse ovaries in the presence of ISCK03, suggesting that the increase in ZIP6 levels results in zinc overload in the oocytes of cultured neonatal mouse ovaries. Further experiments indicated that zinc overload resulted in oocyte apoptosis in cultured neonatal mouse ovaries via oxidative stress-driven dual mechanisms: irreversible DNA damage in the nucleus and autophagic flux blockade in the cytoplasm of oocytes. Moreover, the intraperitoneal injection of ZnSO₄ and ISCK03 significantly increased ZIP6 expression, DNA damage, autophagic flux blockade, and apoptosis of oocytes in neonatal mice. Taken together, these findings indicate that granulosa cell-secreted KITL is involved in maintaining zinc homeostasis in the oocytes of neonatal mouse ovaries. This study not only reveals a novel function of granulosa cells in supporting oocyte homeostasis, but also provides a theoretical basis for identifying individuals susceptible to zinc dyshomeostasis caused by the impaired KITL-KIT signaling. Full article

Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine–metabolic disorder characterized by endocrine disruption, insulin resistance, hyperandrogenism, and chronic low-grade inflammation, in which oxidative stress has been proposed as a mechanistic link between metabolic and reproductive dysfunction. This narrative review summarizes current evidence on redox-related mechanisms and evaluates dietary and supplemental antioxidants in PCOS. Clinical trials, systematic reviews, and mechanistic studies were examined to assess antioxidant classification, signaling pathways, and outcomes related to metabolic, endocrine, reproductive, and oxidative stress parameters. Antioxidant interventions frequently modify circulating redox biomarkers and may improve selected metabolic indices; however, consistent effects on hormonal regulation, ovulation, and long-term clinical outcomes remain limited and heterogeneous. Differences in study design, antioxidant formulation and dosage, baseline metabolic status, and outcome selection complicate interpretation, while emerging evidence suggests modulation by lifestyle factors and gut microbiota-related mechanisms. Overall, antioxidants appear to act primarily through modulation of endogenous redox regulation rather than direct reactive oxygen species scavenging and are best considered adjuncts to lifestyle-based management. Further phenotype-informed and longitudinal studies using clinically relevant endpoints are required to clarify therapeutic relevance in PCOS. Full article

Oxidative stress has emerged as a key factor regulating female fertility, reproductive aging, and the development of various gynecologic and pregnancy-associated diseases. While physiological concentrations of reactive oxygen species play a fundamental role in many aspects of normal reproduction such as folliculogenesis, oocyte maturation, implantation, and placental development, abnormal or chronic oxidative stress impairs redox homeostasis and promotes mitochondrial dysfunction, inflammation, DNA damage, and cellular senescence. Recent research interest has shifted toward next-generation dietary antioxidants, including bioactive polyphenols, carotenoids, micronutrients, and nutraceutical combinations with improved bioavailability and molecular targets. These compounds go beyond classical free-radical scavenging activity and modulate a network of redox-sensitive signaling pathways involved in autophagy, apoptosis, endocrine regulation, and immunological balance. In this review, we integrate current mechanistic advances into a cohesive framework that illustrates the regulation of key cellular processes affecting female reproductive physiology by next-generation dietary antioxidants. We also critically evaluate experimental, translational, and clinical data supporting their role in promoting reproductive outcomes, including oocyte quality, ovarian reserve, pregnancy success, and mitigation of age-related reproductive decline. We highlight their potential in the therapeutic intervention of oxidative stress-related conditions such as infertility, polycystic ovary syndrome, endometriosis, early ovarian insufficiency, and menopause-associated disorders. Finally, we discuss the current challenges associated with dosage optimization, bioavailability, long-term safety, and interindividual variability. We conclude by highlighting next-generation dietary antioxidants as a promising, widely available, and non-invasive approach to improve women’s reproductive health and promote fertility throughout their lifespan. Full article

Background: Miscarriage is the most common complication of pregnancy. Current trends in medicine point to the increasing importance of evidence-based personalization in diagnostic and therapeutic processes. Purpose: The aim of this study was to develop an innovative prenatal screening panel and treatment strategy for miscarriage prevention. Results: Previous studies have demonstrated an imbalance between oxidative and anti-oxidant mechanisms, resulting in systemic oxidative stress in women with a history of miscarriage. The importance of monitoring toxic metal concentrations as potential risk factors in early pregnancy was confirmed. The involvement of NETs in the pathogenesis of miscarriages was demonstrated, while identifying early biomarkers of this process. The effect of BPA on the activation of NETs and the development of an inflammatory response in the female participants was demonstrated. Furthermore, a mechanism of NO-dependent oxidative–anti-oxidative imbalance and NLRP3 inflammasome activation during pregnancy loss was identified in a pathway independent of NET formation, excluding apoptosis. The participation of certain microRNA molecules in reproductive failure and their value in minimally invasive diagnostics in the early stages of pregnancy have been proven. Conclusions: The proposed screening panel accounts for the above parameters, represents a novel approach in modern prenatal care, and prioritizes miscarriage prevention strategies. Full article