The Significant Role of Antioxidant Enzymes in The Pathogenesis and Potential Enhancement of Infertility

Infertility, a global health concern affecting millions, is progressively connected to oxidative stress, an imbalance between the production of reactive oxygen species (ROS) and the susceptibility of the antioxidant defense system. Male is solely responsible for about 20% and a causative factor in about 30% to 40% of cases. But women decline steadily with age, especially at aged 35 years or older after 6 months of unprotected sex. Antioxidant enzymes, like catalase (CAT), superoxide dismutase (SOD), peroxiredoxins (PRXs), glutathione peroxidase (GPx), glutathione reductase (GR), and the four enzymes of the ascorbate–glutathione pathway, which symbolizes an essential endogenous defense mechanism against ROS-induced cellular impairment in the reproductive system of both males and females. This review scrutinized current studies by explaining the crucial role of these enzymes in the pathogenesis of infertility. In males, compromised antioxidant enzyme activity in seminal plasma and spermatozoa contributes to elevated oxidative stress, leading to dysfunctional sperm motility, viability, DNA fragmentation, and finally diminished fertilization possibilities. Likewise, in females, dysregulation of antioxidant enzyme levels in follicular fluid and the reproductive tract can negatively affect the quality of oocytes, endometrial receptivity, and contribute to conditions like polycystic ovary syndrome (PCOS) and endometriosis, which are associated with infertility. Conversely, it is recommended that interventions aimed at improving antioxidant enzyme activity, either by direct supplementation of enzymatic cofactors or indirectly through wide-range of antioxidant therapies and lifestyle modifications, may give opportunities for improving reproductive resolution in both sexes. Finally, this review particularly inform the critical role of antioxidant enzymes in maintaining redox homeostasis within the reproductive system and evaluate their potential as therapeutic targets in solving infertility issues.