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Molecular Pathways to Infertility

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pathology, Diagnostics, and Therapeutics".

Deadline for manuscript submissions: 31 October 2026 | Viewed by 2110

Special Issue Editor


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Guest Editor
Department of Obstetrics and Gynecology, Patras University School of Medicine, Patras, Greece
Interests: female infertility; endometriosis; male infertility; ovarian stimulation; ovarian ageing

Special Issue Information

Dear Colleagues,

Infertility is a complex condition affecting 5–15% of reproductive-age couples. Multifactorial etiologies at the molecular, genetic, hormonal, and cellular levels are involved in the inability of couples to achieve a pregnancy. Disruptions in key molecular pathways can compromise gametogenesis, fertilization, embryo development, and implantation.

The scope of this Special Issue is to describe the molecular pathways leading to infertility. These pathways concern hormonal regulation, genetic and epigenetic alterations, oxidative stress, immunity and inflammation, apoptosis, mitochondrial dysfunction, and defects in DNA repair mechanisms.

A comprehensive understanding of these pathways is essential for identifying the underlying causes of idiopathic infertility. It will improve the diagnostic precision and the development of targeted therapeutic interventions.

Dr. Apostolos Kaponis
Guest Editor

Manuscript Submission Information

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Keywords

  • infertility
  • molecules
  • meiotic arrest
  • premature ovarian insufficiency
  • sperm function
  • progesterone resistance
  • mitochondrial dysfunction
  • epigenetic dysregulation

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Published Papers (2 papers)

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Review

24 pages, 1328 KB  
Review
Leptin Receptor b (LEPRb) Mutations Disrupt Hypothalamic Control of the Reproductive Axis
by Athanasios Zikopoulos, Efthalia Moustakli, Periklis Katopodis, Vasilis Sebastian Paraschos, Anastasios Potiris, Ismini Anagnostaki, Aikaterini Lydia Vogiatzoglou, Konstantinos Zacharis, Theodoros Karampitsakos, Konstantinos Zikopoulos and Sofoklis Stavros
Int. J. Mol. Sci. 2026, 27(5), 2482; https://doi.org/10.3390/ijms27052482 - 8 Mar 2026
Viewed by 478
Abstract
Adipocytes produce the hormone leptin, a hormone that links energy availability to reproductive function by permitting activation of the hypothalamic–pituitary–gonadal (HPG) axis. Loss-of-function mutations in the long leptin receptor isoform (LEPRb) disrupt intracellular signaling pathways, including the Janus kinase 2 (JAK2)/signal transducer and [...] Read more.
Adipocytes produce the hormone leptin, a hormone that links energy availability to reproductive function by permitting activation of the hypothalamic–pituitary–gonadal (HPG) axis. Loss-of-function mutations in the long leptin receptor isoform (LEPRb) disrupt intracellular signaling pathways, including the Janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3), phosphoinositide 3-kinase (PI3K), and mitogen-activated protein kinase (MAPK) pathways, resulting in central leptin resistance and impaired neuroendocrine control of reproduction. Evidence from human monogenic obesity syndromes, animal models, and neuroendocrine studies indicates that LEPRb mutations disrupt hypothalamic circuitry upstream of gonadotropin-releasing hormone (GnRH) neurons, impairing GnRH pulsatility and leading to hypogonadotropic hypogonadism (HH) and infertility. This review synthesizes molecular, translational, and clinical data highlighting the central role of kisspeptin-mediated signaling in leptin-dependent reproductive regulation. Current therapeutic limitations are discussed alongside emerging approaches, including kisspeptin-based therapies and receptor-targeted strategies. Elucidating how LEPRb dysfunction disrupts metabolic–reproductive integration may provide insights into both rare monogenic conditions and common obesity-associated reproductive dysfunction. Full article
(This article belongs to the Special Issue Molecular Pathways to Infertility)
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21 pages, 512 KB  
Review
Genetic and Epigenetic Risks of Male Infertility in ART
by Athanasios Zikopoulos, Periklis Katopodis, Maria Filiponi, Athanasios Zachariou, Athanasia Sesse, Ioanna Bouba, Charilaos Kostoulas, Sofia Markoula and Ioannis Georgiou
Int. J. Mol. Sci. 2025, 26(24), 11812; https://doi.org/10.3390/ijms262411812 - 7 Dec 2025
Cited by 1 | Viewed by 1282
Abstract
Assisted reproductive technologies (ART) and, in particular, intracytoplasmic sperm injection (ICSI) transformed the management of male infertility by making fertility possible in previously untreatable cases. However, the bypassing of natural selection mechanisms at fertilization is fraught with the danger of transmission of genetic [...] Read more.
Assisted reproductive technologies (ART) and, in particular, intracytoplasmic sperm injection (ICSI) transformed the management of male infertility by making fertility possible in previously untreatable cases. However, the bypassing of natural selection mechanisms at fertilization is fraught with the danger of transmission of genetic and epigenetic abnormalities. Male infertility is now a multifactorial disorder with notable contributions from single-gene defects, chromosomal abnormalities, and Y-chromosome microdeletions. The recent advances in next-generation sequencing and sperm omics have identified mutations and copy-number variations in genes critical for spermatogenesis, flagellar structure, and endocrine regulation. Along with these findings, an increasing body of evidence suggests that ART procedures can lead to a disruption of epigenetic reprogramming during gametogenesis and early embryogenesis, resulting in imprinting disorders and altered patterns of gene expression in the offspring. This review synthesizes recent progress in the molecular underpinnings of genetic and epigenetic hazards of ART, with an emphasis on clinical significance for reproductive counselling and ethical considerations for future generations. Full article
(This article belongs to the Special Issue Molecular Pathways to Infertility)
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