Role of Oxidative Stress in Male and Female Infertility: Pathophysiology, Molecular Mechanisms, Diagnosis, and Therapeutic Perspectives.

Infertility is a multifaceted reproductive disorder that affects about 15% of couples and constitutes a significant health burden with medical, psychological and socioeconomic implications. Historically, infertility has been linked to anatomical, hormonal and genetic defects; however, recent research has shown that oxidative stress is a key factor in the pathophysiology of male and female infertility. Overproduction of reactive oxygen species (ROS) can interfere with spermatogenesis, inhibit oocyte maturation and cause DNA damage, resulting in impaired embryo quality. Further, oxidative stress has been implicated in mitochondrial dysfunction, activation of apoptosis and inflammatory pathways such as nuclear factor kappa-B (NF-κB) and nuclear factor erythroid 2–related factor 2 (Nrf2(. The present review gives an extensive description of the epidemiology, pathophysiology, etiology, mechanism, diagnosis, and management of infertility, with special emphasis on oxidative stress. In order to conduct a systematic analysis of the existing literature, a comprehensive search for literature using specific inclusion criteria was carried out on several databases. The present review also highlights the recent advances in the field of antioxidant therapy, assisted conception, and molecular diagnostics that may increase fertility.