Introduction: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age which has been associated with impaired fertility and negatively affects various health systems. Despite a long history of studies on PCOS, its etiology is still unknown. Studies have shown oxidative stress plays a central role in the pathophysiology of many different disorders, including PCOS. Reactive oxygen and nitrogen species (RONS) are produced by several endogenous and exogenous processes, and their negative effects are neutralized by antioxidant defenses. Oxidative stress (OS) occurs from the imbalance between RONS production and these antioxidant defenses. This article reviews the literature data related to the mechanisms of oxidative stress in PCOS.
Methods: In order to find relevant studies to the research question, an electronic search with time (recent five years, up to 2021) and language (English) restrictions was conducted using PubMed. The search terms included “Polycystic ovary syndrome,” “PCOS,” “Reactive oxygen species (ROS),” “Oxidative marker,” “Oxidative stress (OS),” “Antioxidant were used individually or/and in various combinations to retrieve the relevant literatures. Most recent studies including case control studies, original research and review articles were selected.
Results: For investigation of the oxidative stress role in the pathogenesis of diseases, mainly, studies have examined oxidative stress biomarkers including malondialdehyde (MDA) and Nitric oxide (NO) also anti-oxidative biomarkers such as Total antioxidant capacity (TAC). Results of these studies showed higher level of MDA, NO, Advanced glycosylated end products (AGEs) and Xanthine Oxidase (XO) in PCOS women. One meta-analysis showed that there was no significant difference in TAC in women with PCOS compared with control, however in two original studies higher and lower level of TAC was reported.
Conclusion: The association between oxidative stress and PCOS is an important issue in human reproductive medicine. In general, an association between oxidative stress and PCOS has been established in different studies. However, conflicts still exist. Results of studies about antioxidant concentration are conflicting; therefore, further studies of oxidative stress in PCOS are needed to clarify the association PCOS with antioxidants.