Metabolic, Immune, and Inflammatory Mechanisms in Female Reproductive Disorders and Pregnancy Complications: A Narrative Review

Female reproductive disorders and pregnancy complications are increasingly recognized as multifactorial conditions involving complex interactions among metabolic, immunological, and inflammatory pathways. This narrative review synthesizes current evidence on the interplay between metabolic dysregulation, immune maladaptation, and inflammatory activation in the development of infertility and adverse pregnancy outcomes. A structured literature search was conducted using PubMed, Web of Science, and Scopus for studies published between 2010 and 2025. Relevant articles addressing metabolic, immune, and inflammatory mechanisms in female reproductive disorders and pregnancy complications were selected and qualitatively analyzed. The findings indicate that metabolic disturbances including insulin resistance, dyslipidemia, and endocrine dysfunctionact as initiating factors in reproductive pathology. These alterations are closely associated with immune dysregulation, particularly impaired maternal–fetal tolerance and endothelial dysfunction. Inflammatory activation, characterized by elevated cytokines such as interleukin-6 and interleukin-1β, serves as a key mediator linking metabolic and immune pathways to clinical manifestations. Severe complications, including preeclampsia and HELLP syndrome, represent the convergence of these mechanisms and are associated with increased maternal and fetal risks. These interconnected pathways have direct clinical implications for early diagnosis and risk stratification in obstetric practice. Female reproductive disorders and pregnancy complications should therefore be understood within an integrated metabolic-immune-inflammatory framework, an approach that may facilitate the identification of novel biomarkers and support the development of targeted therapeutic strategies.