{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:35:29Z","timestamp":1790800529030,"version":"4.1.0"},"reference-count":91,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Oxidative balance within follicular fluid (FF) plays an important role in oocyte competence and female fertility. However, most previous studies have focused on isolated oxidative biomarkers rather than on the coordinated organization of the follicular redox system. This study aimed to identify system-level oxidative phenotypes within FF and evaluate their associations with infertility-related clinical and metabolic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seventy-seven women undergoing IVF treatment were included. Nineteen oxidative and antioxidative biomarkers were measured in FF collected separately from both ovaries. Bayesian multivariable regression with Markov chain Monte Carlo inference was combined with directional indicator analysis and unsupervised taxonomic clustering to identify latent oxidative phenotypes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Two structurally distinct and antagonistically organized oxidative phenotypes were identified within FF. Phenotype 1 comprised biomarkers representing the primary antioxidant defense system, whereas Phenotype 2 included enzymes involved predominantly in secondary detoxification pathways. Idiopathic infertility and BMI demonstrated significant and opposite directional effects across the two phenotypes. Specifically, increasing BMI and idiopathic infertility were associated with decreased activity of biomarkers belonging to Phenotype 1 and increased activity of biomarkers assigned to Phenotype 2 (p = 0.0177 and p = 0.0097, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The follicular redox environment demonstrates a polarized and system-level biochemical architecture rather than uniform oxidative alterations. BMI and idiopathic infertility appear to selectively reorganize oxidative pathways within FF through opposite effects on two antagonistically structured phenotypes. These findings suggest a shared pathophysiological mechanism reorganizing the follicular antioxidant network in both conditions and challenge the single-biomarker paradigm in reproductive oxidative stress research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1890028","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T04:19:45Z","timestamp":1784607585000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["BMI and idiopathic infertility drive polarized redox phenotypes in human follicular fluid"],"prefix":"10.3389","volume":"17","author":[{"given":"Katarzyna","family":"Olszak-W\u0105sik","sequence":"first","affiliation":[{"name":"Department of Gynaecology, Obstetrics and Oncological Gynaecology","place":["Bytom, Poland"]},{"name":"Department of Gynaecology, Obstetrics and Oncological Gynaecology, Faculty of Medical Sciences in Zabrze","place":["Zabrze, Poland"]},{"name":"The Fertility Partnership (TFP) Fertility Macierzy\u0144stwo","place":["Krak\u00f3w, Poland"]},{"name":"TFP Fertility Vitrolive","place":["Szczecin, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrzej","family":"Tukiendorf","sequence":"additional","affiliation":[{"name":"Opole University of Technology, Faculty of Physical Education and Physiotherapy","place":["Opole, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafa\u0142","family":"Kurzawa","sequence":"additional","affiliation":[{"name":"The Fertility Partnership (TFP) Fertility Macierzy\u0144stwo","place":["Krak\u00f3w, Poland"]},{"name":"TFP Fertility Vitrolive","place":["Szczecin, Poland"]},{"name":"Department of Gynecology and Reproductive Health, Pomeranian Medical University","place":["Antalya, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iwona","family":"Kulik-Parobczy","sequence":"additional","affiliation":[{"name":"Opole University of Technology, Faculty of Physical Education and Physiotherapy","place":["Opole, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayla","family":"Sarg\u0131n","sequence":"additional","affiliation":[{"name":"IVF Department, Antalya Life Hospital (Ya\u015fam Hastanesi)","place":["Antalya, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Kasperczyk","sequence":"additional","affiliation":[{"name":"Medical University of Silesia, Poland; Department of Biochemistry, Faculty of Medical Sciences in Zabrze","place":["Zabrze, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deae292","article-title":"Global, regional, and national prevalence and trends of infertility among individuals of reproductive age (15-49 years) from 1990 to 2021, with projections to 2040","volume":"40","author":"Liang","year":"2025","journal-title":"Hum Reprod"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dead150","article-title":"Evidence-based guideline: unexplained infertility","volume":"38","author":"Romualdi","year":"2023","journal-title":"Hum Reprod"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3389\/frph.2026.1753325","article-title":"Fertility awareness methods and waiting conduct in idiopathic infertility: a prospective observational study","volume":"8","author":"Barbato","year":"2026","journal-title":"Front Reprod Health"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1186\/s13048-024-01551-9","article-title":"Unraveling the complexity of follicular fluid: insights into its composition, function, and clinical implications","author":"Pan","year":"2024","journal-title":"J Ovarian Res"},{"key":"B5","doi-asserted-by":"publisher","first-page":"6377","DOI":"10.3390\/ijms26136377","article-title":"Cracking the code of oocyte quality: the oxidative stress link to IVF success","volume":"26","author":"Voros","year":"2025","journal-title":"Int J Mol Sci"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3390\/biom15030443","article-title":"Associations between follicular fluid biomarkers and IVF\/ICSI outcomes in normo-ovulatory women\u2014a systematic review","author":"Albeitawi","year":"2025","journal-title":"Biomolecules"},{"key":"B7","doi-asserted-by":"publisher","first-page":"110522","DOI":"10.1016\/j.mce.2019.110522","article-title":"Progressive changes in human follicular fluid composition over the course of ovulation: quantitative proteomic analyses","volume":"495","author":"Poulsen","year":"2019","journal-title":"Mol Cell Endocrinol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"2117","DOI":"10.3390\/antiox12122117","article-title":"The impact of follicular fluid oxidative stress levels on the outcomes of assisted reproductive therapy","volume":"12","author":"Chen","year":"2023","journal-title":"Antioxidants"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3390\/antiox11071335","article-title":"Oxidative stress and human ovarian response\u2014from somatic ovarian cells to oocytes damage: a clinical comprehensive narrative review","author":"Immediata","year":"2022","journal-title":"Antioxidants"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1186\/s13048-022-01032-x","article-title":"The role of oxidative stress in ovarian aging: a review","author":"Yan","year":"2022","journal-title":"J Ovarian Res"},{"key":"B11","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1093\/biolre\/ioaf032","article-title":"Reactive oxygen and nitrogen species: multifaceted regulators of ovarian activity","author":"Bezd\u00ed\u010dek","year":"2025","journal-title":"Biol Reprod"},{"key":"B12","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1210\/er.2018-00075","article-title":"Ovulation: parallels with inflammatory processes","volume":"40","author":"Duffy","year":"2019","journal-title":"Endocr Rev"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1017\/S0967199420000179","article-title":"Reactive oxygen species in reproduction: harmful, essential or both","volume":"28","author":"Jamil","year":"2020","journal-title":"Zygote"},{"key":"B14","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1016\/j.fertnstert.2022.04.019","article-title":"Mitochondrial dysfunction in cumulus cells is related to decreased reproductive capacity in advanced-age women","volume":"118","author":"Lu","year":"2022","journal-title":"Fertil Steril"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3390\/antiox12081490","article-title":"The silent threat to women\u2019s fertility: uncovering the devastating effects of oxidative stress","author":"Kaltsas","year":"2023","journal-title":"Antioxidants"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1530\/RAF-23-0024","article-title":"Role of oxidative stress in male infertility","author":"Takalani","year":"2023","journal-title":"Reprod Fertil"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1038\/s12276-024-01178-2","article-title":"Distinct characteristics of the DNA damage response in mammalian oocytes","volume":"56","author":"Leem","year":"2024","journal-title":"Exp Mol Med"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1186\/s13048-025-01633-2","article-title":"Follicular metabolic dysfunction, oocyte aneuploidy and ovarian aging: a review","author":"Wu","year":"2025","journal-title":"J Ovarian Res"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2014.11.015","article-title":"Oocyte environment: follicular fluid and cumulus cells are critical for oocyte health","volume":"103","author":"Dumesic","year":"2015","journal-title":"Fertil Steril"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1007\/s00204-024-03696-4","article-title":"Several lines of antioxidant defense against oxidative stress: antioxidant enzymes, nanomaterials with multiple enzyme-mimicking activities, and low-molecular-weight antioxidants","author":"Jomova","year":"2024","journal-title":"Arch Toxicol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25179409","article-title":"The role of selected elements in oxidative stress protection: key to healthy fertility and reproduction","author":"Wr\u00f3blewski","year":"2024","journal-title":"Int J Mol Sci"},{"key":"B22","doi-asserted-by":"publisher","first-page":"e87283","DOI":"10.7759\/cureus.87283","article-title":"Obesity epidemic and its impact on female fertility: current understanding and future directions","volume":"17","author":"Malhotra","year":"2025","journal-title":"Cureus"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1002\/aro2.82","article-title":"Obesity and oxidative stress: implications for female fertility","author":"Heng","year":"2024","journal-title":"Anim Res One Health"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.3390\/biom15070923","article-title":"Role of granulosa cell dysfunction in women infertility associated with polycystic ovary syndrome and obesity","author":"Chauvin","year":"2025","journal-title":"Biomolecules"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.metop.2026.100469","article-title":"Influence of metabolic syndrome on infertility: a review","volume":"30","author":"Tesfa","year":"2026","journal-title":"Metabol Open"},{"key":"B26","doi-asserted-by":"publisher","first-page":"100560","DOI":"10.1016\/j.coemr.2024.100560","article-title":"Adipose tissue-derived mediators of systemic inflammation and metabolic control","volume":"37","author":"Alexaki","year":"2024","journal-title":"Curr Opin Endocr Metab Res"},{"key":"B27","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1186\/1477-7827-10-49","article-title":"The effects of oxidative stress on female reproduction: a review","volume":"10","author":"Agarwal","year":"2012","journal-title":"Reprod Biol Endocrinol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1592683","DOI":"10.3389\/fendo.2025.1592683","article-title":"Adipose tissue dysfunction disrupts metabolic homeostasis: mechanisms linking fat dysregulation to disease","volume":"16","author":"Bou Matar","year":"2025","journal-title":"Front Endocrinol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1186\/s13048-023-01293-0","article-title":"Oxidative stress and inflammatory markers in ovarian follicular fluid of women with diminished ovarian reserve during in vitro fertilization","volume":"16","author":"Huang","year":"2023","journal-title":"J Ovarian Res"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1477-7827-7-40","article-title":"Follicular fluid content and oocyte quality: from single biochemical markers to metabolomics","volume":"7","author":"Revelli","year":"2009","journal-title":"Reprod Biol Endocrinol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2011.09.032","article-title":"Correlations of follicular fluid oxidative stress biomarkers and enzyme activities with embryo morphology parameters during in vitro fertilization","volume":"96","author":"Fujimoto","year":"2011","journal-title":"Fertil Steril"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.5114\/pm.2022.124019","article-title":"Oxidative homeostasis in follicular fluid and reproductive outcomes \u2013 from bench to bedside","author":"Zec","year":"2022","journal-title":"Przeglad Menopauzalny"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/J.SEMERG.2025.102670","article-title":"The effect of obesity on fertility: a systematic review","volume":"52","author":"Efstratiou","year":"2026","journal-title":"Med Familia SEMERGEN"},{"key":"B34","doi-asserted-by":"publisher","first-page":"590","DOI":"10.1515\/mr-2022-0031","article-title":"Ovarian aging: mechanisms and intervention strategies","volume":"2","author":"Zhu","year":"2022","journal-title":"Med Rev"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1080\/09513590312331290418","article-title":"Vascular endothelial growth factor in females of reproductive age","volume":"17","author":"Artini","year":"2003","journal-title":"Gynecol Endocrinol"},{"key":"B36","doi-asserted-by":"publisher","first-page":"e240197","DOI":"10.1530\/REP-24-0197","article-title":"The effect of chronic inflammation on female fertility","volume":"169","author":"Ameho","year":"2025","journal-title":"Reproduction"},{"key":"B37","doi-asserted-by":"publisher","first-page":"1324429","DOI":"10.3389\/fendo.2023.1324429","article-title":"Chronic low-grade inflammation and ovarian dysfunction in women with polycystic ovarian syndrome, endometriosis, and aging","volume":"14","author":"Orisaka","year":"2023","journal-title":"Front Endocrinol"},{"key":"B38","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12958-020-00631-x","article-title":"Human follicular fluid shows diverse metabolic profiles at different follicle developmental stages","volume":"18","author":"Yang","year":"2020","journal-title":"Reprod Biol Endocrinol"},{"key":"B39","doi-asserted-by":"publisher","first-page":"20250468","DOI":"10.1098\/rsif.2025.0468","article-title":"From reductionism to realism: holistic mathematical modelling for complex biological systems","volume":"22","author":"Nartallo-Kaluarachchi","year":"2025"},{"key":"B40","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1186\/s12916-023-02858-y","article-title":"Statistical analysis of high-dimensional biomedical data: a gentle introduction to analytical goals, common approaches and challenges","volume":"21","author":"Rahnenf\u00fchrer","year":"2023","journal-title":"BMC Med"},{"key":"B41","unstructured":"Clustering-based outcome models for clinical studies: a scoping review\n          \n          \n            \n              Vilsmeier\n              J\n            \n            \n              Eibensteiner\n              F\n            \n            \n              K\u00f6nig\n              F\n            \n            \n              Mercier\n              F\n            \n            \n              Ristl\n              R\n            \n            \n              Stallard\n              N\n            \n          \n          \n          2026"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1016\/0003-2697(84)90467-6","article-title":"Reevaluation of assay methods and establishment of kit for superoxide dismutase activity","author":"Oyanagui","year":"1984","journal-title":"Anal Biochem"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1016\/0003-2697(88)90554-4","article-title":"A spectrophotometric method for determination of catalase activity in small tissue samples","author":"Johansson","year":"1988","journal-title":"Anal Biochem"},{"key":"B44","article-title":"Studies on the quantitative and qualitative characterization of erythrocyte glutathione peroxidase","volume":"70","author":"Paglia","year":"1967","journal-title":"J Lab Clin Med"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtemb.2014.12.007","article-title":"The influence of macro and trace elements on sperm quality","volume":"30","author":"Kasperczyk","year":"2015","journal-title":"J Trace Elem Med Biol"},{"key":"B46","volume-title":"Clinical Chemistry","author":"Richterich","year":"1971"},{"key":"B47","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1016\/S0076-6879(81)77053-8","article-title":"Assays for differentiation of glutathione S-transferases","volume":"77","author":"Habig","year":"1981","journal-title":"Methods Enzymol"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2003.11.015","article-title":"A novel automated direct measurement method for total antioxidant capacity using a new generation, more stable ABTS radical cation","volume":"37","author":"Erel","year":"2004","journal-title":"Clin Biochem"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1136\/ard.45.1.44","article-title":"Intracellular and extracellular sulphydryl levels in rheumatoid arthritis","author":"Koster","year":"1986","journal-title":"Ann Rheum Dis"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2005.08.008","article-title":"A new automated colorimetric method for measuring total oxidant status","volume":"38","author":"Erel","year":"2005","journal-title":"Clin Biochem"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1172\/JCI111958","article-title":"In vivo externalization of phosphatidylserine and phosphatidylethanolamine in the membrane bilayer and hypercoagulability by the lipid peroxidation of erythrocytes in rats","author":"Jain","year":"1985"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1016\/0003-2697(79)90738-3","article-title":"Assay for lipid peroxides in animal tissues by thiobarbituric acid reaction","volume":"95","author":"Ohkawa","year":"1979","journal-title":"Anal Biochem"},{"key":"B53","volume-title":"Winbugs User Manual","author":"Spiegelhalter","year":"2007"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.4064\/cm-6-1-319-327","article-title":"On a certain distance of sets and the corresponding distance of functions","volume":"6","author":"Marczewski","year":"1958","journal-title":"Colloq Math"},{"key":"B55","doi-asserted-by":"crossref","DOI":"10.1002\/9780470316801","volume-title":"Finding Groups in Data: An Introduction to Cluster Analysis","author":"Kaufman","year":"1990"},{"key":"B56","volume-title":"A Language and Environment for Statistical Computing","year":"2024"},{"key":"B57","volume-title":"Cluster Analysis Basics and Extensions. R Package Version. 2.1.8.2","author":"Maechler","year":"2024"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.1016\/j.redox.2026.104167","article-title":"Oxidative stress biomarkers in assisted reproductive technologies: From follicular redox biology to clinical translation","volume":"93","author":"Lin","year":"2026","journal-title":"Redox Biol"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1515\/jomb-2017-0001","article-title":"Oxidative stress markers in GnRH agonist and antagonist protocols in IVF","volume":"36","author":"Tuli\u0107","year":"2017","journal-title":"J Med Biochem"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.1093\/molehr\/gap034","article-title":"Superoxide dismutase expression in human cumulus oophorus cells","volume":"15","author":"Matos","year":"2009","journal-title":"Mol Hum Reprod"},{"key":"B61","doi-asserted-by":"publisher","first-page":"2589","DOI":"10.3390\/ijms24032589","article-title":"Follicular fluid components in reduced ovarian reserve, endometriosis, and idiopathic infertility","volume":"24","author":"Collodel","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B62","doi-asserted-by":"publisher","first-page":"1444832","DOI":"10.3389\/fendo.2025.1444832","article-title":"The role of oxidative balance lifestyle factors in reducing female infertility risk: Insights from a population-based study","volume":"16","author":"Xia","year":"2025","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B63","doi-asserted-by":"publisher","first-page":"848","DOI":"10.3390\/antiox14070848","article-title":"Manganese superoxide dismutase: Structure, function, and implications in human disease","volume":"14","author":"Grujicic","year":"2025","journal-title":"Antioxidants"},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2019.01638","article-title":"The impact of oxidative stress on adipose tissue energy balance","author":"Masschelin","year":"2020","journal-title":"Front Physiol"},{"key":"B65","doi-asserted-by":"publisher","DOI":"10.1186\/s12967-025-06966-6","article-title":"Mitochondria-driven inflammation: A new frontier in ovarian ageing","author":"Ju","year":"2025","journal-title":"J Transl Med"},{"key":"B66","doi-asserted-by":"publisher","DOI":"10.3390\/ijms26094098","article-title":"The importance of mitochondrial processes in the maturation and acquisition of competences of oocytes and embryo culture","author":"Ga\u0142\u0119ska","year":"2025","journal-title":"Int J Mol Sci"},{"key":"B67","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1186\/s13048-025-01764-6","article-title":"Mitochondrial dysfunction in oocytes: Implications for fertility and ageing","volume":"18","author":"Wang","year":"2025","journal-title":"J Ovarian Res"},{"key":"B68","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-58323-0","article-title":"Follicular metabolic alterations are associated with obesity in mares and can be mitigated by dietary supplementation","volume":"14","author":"Catandi","year":"2024","journal-title":"Sci Rep"},{"key":"B69","doi-asserted-by":"publisher","DOI":"10.5935\/1518-0557.20250173","article-title":"Oxidative-antioxidant status of follicular fluid in IVF patients: Influence of ovarian response and oocyte-cumulus complex morphology","volume":"30","author":"\u00c1lvarez Asensio","year":"2026","journal-title":"J Bras Reprod Assist"},{"key":"B70","doi-asserted-by":"publisher","DOI":"10.3390\/ijms27020950","article-title":"Oxidative stress and SIRT1-Nrf2 anti-ferroptotic pathways in granulosa cells: A molecular key to follicular atresia and ovarian aging","volume":"27","author":"Voros","year":"2026","journal-title":"Int J Mol Sci"},{"key":"B71","doi-asserted-by":"publisher","DOI":"10.3390\/antiox12111923","article-title":"Serum oxidative status in people with obesity: Relation to tissue losses, glucose levels, and weight reduction","volume":"12","author":"Szlachta","year":"2023","journal-title":"Antioxidants"},{"key":"B72","doi-asserted-by":"publisher","first-page":"6501046","DOI":"10.1155\/2017\/6501046","article-title":"Measurement and clinical significance of biomarkers of oxidative stress in humans","volume":"2017","author":"Marrocco","year":"2017","journal-title":"Oxid Med Cell Longevity"},{"key":"B73","doi-asserted-by":"publisher","DOI":"10.4103\/njcp.njcp_836_23","article-title":"The role of total oxidant and antioxidant levels in follicular fluid in unexplained infertility","volume":"27","author":"Topdagi","year":"2024","journal-title":"Niger J Clin Pract"},{"key":"B74","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1007\/978-1-4899-5339-1_2","article-title":"Lipofuscin as an indicator of oxidative stress and aging","volume":"266","author":"Sohal","year":"1989","journal-title":"Adv Exp Med Biol"},{"key":"B75","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1038\/s41514-024-00157-1","article-title":"The role of cellular senescence in ovarian aging","volume":"10","author":"Hense","year":"2024","journal-title":"NPJ Aging"},{"key":"B76","doi-asserted-by":"publisher","DOI":"10.1007\/s11357-022-00573-9","article-title":"Senolytic treatment reverses obesity-mediated senescent cell accumulation in the ovary","volume":"44","author":"Hense","year":"2022","journal-title":"Geroscience"},{"key":"B77","doi-asserted-by":"publisher","DOI":"10.1083\/jcb.201708007","article-title":"Superoxide dismutases: Dual roles in controlling ROS damage and regulating ROS signaling","author":"Wang","year":"2018","journal-title":"J Cell Biol"},{"key":"B78","doi-asserted-by":"publisher","DOI":"10.1016\/J.BBAMCR.2018.02.010","article-title":"Nrf2-Keap1 signaling in oxidative and reductive stress","volume":"1865","author":"Bellezza","year":"2018","journal-title":"Biochim Biophys Acta (BBA)  Mol Cell Res"},{"key":"B79","doi-asserted-by":"publisher","first-page":"86","DOI":"10.3390\/antiox6040086","article-title":"Insights into the dichotomous regulation of SOD2 in cancer","volume":"6","author":"Kim","year":"2017","journal-title":"Antioxidants"},{"key":"B80","doi-asserted-by":"publisher","DOI":"10.1089\/ars.2017.7342","article-title":"Transcriptional regulation by Nrf2","author":"Tonelli","year":"2018","journal-title":"Antioxid Redox Signaling"},{"key":"B81","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.00311.2017","article-title":"Nrf2 deletion from adipocytes, but not hepatocytes, potentiates systemic metabolic dysfunction after long-term high-fat diet-induced obesity in mice","volume":"315","author":"Chartoumpekis","year":"2018","journal-title":"Am J Physiol Endocrinol Metab"},{"key":"B82","doi-asserted-by":"publisher","first-page":"2067","DOI":"10.3390\/antiox11102067","article-title":"The Nrf2 in obesity: A friend or foe","volume":"11","author":"Xia","year":"2022","journal-title":"Antioxidants"},{"key":"B83","doi-asserted-by":"publisher","DOI":"10.1042\/BST20150014","article-title":"Dissecting molecular cross-talk between Nrf2 and NF-\u03baB response pathways","volume":"43","author":"Wardyn","year":"2015","journal-title":"Biochem Soc Trans"},{"key":"B84","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajpath.2021.12.005","article-title":"The role of inactivated NF-\u03baB in premature ovarian failure","volume":"192","author":"Luo","year":"2022","journal-title":"Am J Pathol"},{"key":"B85","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7827-12-13","article-title":"Fatty acid composition of the follicular fluid of normal weight, overweight and obese women undergoing assisted reproductive treatment: A descriptive cross-sectional study","volume":"12","author":"Valckx","year":"2014","journal-title":"Reprod Biol Endocrinol"},{"key":"B86","doi-asserted-by":"publisher","DOI":"10.22074\/IJFS.2023.555601.1317","article-title":"Association of follicular fluid antioxidants activity with aging and in vitro fertilization outcome: A cross-sectional study","volume":"18","author":"Afrough","year":"2024","journal-title":"Int J Fertil Steril"},{"key":"B87","doi-asserted-by":"publisher","DOI":"10.3390\/antiox8090338","article-title":"Impact of melatonin supplementation in women with unexplained infertility undergoing fertility treatment","volume":"8","author":"Espino","year":"2019","journal-title":"Antioxidants"},{"key":"B88","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines13102434","article-title":"Melatonin in the treatment of female infertility: Update on biological and clinical findings","author":"Tesarik","year":"2025","journal-title":"Biomedicines"},{"key":"B89","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1144323","article-title":"Astaxanthin ameliorates inflammation, oxidative stress, and reproductive outcomes in endometriosis patients undergoing assisted reproduction: A randomized, triple-blind placebo-controlled clinical trial","volume":"14","author":"Rostami","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B90","doi-asserted-by":"publisher","DOI":"10.1007\/s11154-023-09819-z","article-title":"Follicular fluid composition and reproductive outcomes of women with polycystic ovary syndrome undergoing in vitro fertilization: A systematic review","volume":"24","author":"Moreira","year":"2023","journal-title":"Rev Endocr Metab Disord"},{"key":"B91","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(26)00717-8","article-title":"Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: A multistep global consensus process","author":"Teede","year":"2026","journal-title":"Lancet"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1890028\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T04:19:47Z","timestamp":1784607587000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1890028\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,21]]},"references-count":91,"alternative-id":["10.3389\/fendo.2026.1890028"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1890028","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,21]]},"article-number":"1890028"}}