Oxidative stress within the follicular microenvironment plays a critical role in oocyte quality and reproductive outcomes. This prospective study examines the association between follicular fluid redox status, maternal age, ovarian reserve, and clinical outcomes in women undergoing in vitro fertilization. Follicular fluid samples were obtained from women undergoing fresh embryo transfer cycles and analyzed for oxidative damage markers (malondialdehyde, nitric oxide, ischemia-modified albumin, sialic acid) and antioxidant parameters (superoxide dismutase, catalase, glutathione, and thiol-disulfide homeostasis). Participants were stratified according to maternal age (≤35 vs. >35 years), serum estradiol levels on the day of human chorionic gonadotropin trigger (≤90th vs. >90th percentile), and clinical pregnancy outcome. Anti-Müllerian hormone and follicle-stimulating hormone levels were recorded as indicators of ovarian reserve. Women aged >35 years exhibited significantly higher malondialdehyde and sialic acid levels, accompanied by reduced antioxidant enzyme activities. Cycles resulting in clinical pregnancy showed lower oxidative stress and higher antioxidant capacity compared with non-pregnant cycles. Malondialdehyde levels correlated positively with age and follicle-stimulating hormone, while antioxidant parameters correlated positively with anti-Müllerian hormone and pregnancy outcome. Receiver operating characteristic analysis demonstrated moderate discriminative ability of malondialdehyde, superoxide dismutase, catalase, and glutathione for clinical pregnancy. These findings indicate that age-related redox imbalance in follicular fluid is associated with diminished ovarian reserve and reduced in vitro fertilization success. Assessment of follicular fluid oxidative stress parameters may provide clinically relevant insights into female reproductive potential.
Korkmaz et al. (Sat,) studied this question.