Generation ofROS During Assisted Reproduction Techniques

Literature has documented role of OS in the pathophysiology of infertility and assisted fertility [135, 161, 194]. ROS may originate directly from gametes and embryos (endogenous sources) as well as their surroundings (exogenous sources). Several exogenous factors identified in culture media enhance embryo production of ROS: oxygen concentration, the presence of metallic cations, and visible light exposure. Spermatozoa may also aid in the production of ROS during assisted reproduction techniques.

Elevated ROS levels generated exogenously or endogenously influence the gametes, gamete interaction, fertilization, and pregnancy rates with IVF/ICSI. Oxidative insult to embryos can lead to two-cell block, embryonic arrest, or even embryonic demise [213,214]. Higher levels ofROS in the follicular fluid and semen are associated with poor fertility outcomes with assisted reproduction [171, 174]. In a metaanalysis from our group, ROS in semen have been reported to significantly effect the fertilization rate with IVF [161]. Measurement of ROS levels may help counsel patients on their adverse effects. The effects of oxidative stress in an ART setting may be amplified due to the lack of physiological defense mechanisms available and due to the number of potential sources of ROS at play [128].

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