Systemic and embryo culture medium oxidative stress markers in diminished ovarian reserve and unexplained ınfertility: association with IVF outcomes
Year: 2026
Type: article
Study design: Observational Study
Abstract: Diminished ovarian reserve (DOR) and unexplained infertility are significant clinical conditions that can adversely affect IVF success rates. Although the impact of oxidative stress on oocyte quality, embryo development, and implantation is well established, comparative evaluations of systemic and embryo microenvironment–related oxidative stress markers across different infertility groups remain limited. In this study, we aimed to compare oxidative stress parameters in serum and embryo culture medium among patients with DOR and unexplained infertility undergoing IVF treatment, and to investigate the potential impact of these parameters on pregnancy outcomes. A total of 49 patients who underwent an IVF protocol at our clinic between December 2021 and July 2022 were enrolled in this prospective study (33 with unexplained infertility and 16 with diminished ovarian reserve). Baseline hormone levels and complete blood count (CBC) parameters were evaluated from blood samples obtained on the second or third day of the menstrual cycle. Inflammatory markers, including mean platelet volume (MPV), platelet count (PLT), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR), were calculated. In the same blood samples, as well as in the embryo culture medium in which the embryos were maintained from fertilization until embryo transfer, levels of glutathione reductase, glutathione peroxidase, melatonin, and coenzyme Q10 were measured. Pregnancy was defined as biochemical pregnancy when the serum β-hCG level was >5 mIU/mL 14 days after embryo transfer, and as clinical pregnancy when intrauterine fetal cardiac activity was detected by ultrasonography. Serum melatonin levels were found to be significantly higher in patients who achieved pregnancy (p<0.05). When comparing the diminished ovarian reserve and unexplained infertility groups, a statistically significant difference was observed in terms of MPV values (p<0.05). No significant differences were detected between the groups with respect to the other oxidative stress parameters. Serum melatonin emerged as the only oxidative stress parameter independently associated with biochemical pregnancy outcomes following adjustment for infertility etiology and ovarian reserve parameters. Reproductive outcomes were evaluated based on positive pregnancy test and clinical pregnancy rates, as live birth data were not available.
Source: Journal of Ovarian Research
Institutions: Eskişehir City Hospital, Eskişehir Osmangazi University
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,290
OpenAlex ID: W7204077443
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