To identify system-level oxidative phenotypes within follicular fluid and evaluate their associations with infertility-related clinical and metabolic factors.
Approach:
Study Design: Seventy-seven women undergoing IVF treatment were included. Nineteen oxidative and antioxidative biomarkers were measured in follicular fluid collected separately from both ovaries.
Data Analysis: Bayesian multivariable regression with Markov chain Monte Carlo inference was combined with directional indicator analysis and unsupervised taxonomic clustering to identify latent oxidative phenotypes.
Key Findings:
Two structurally distinct and antagonistically organized oxidative phenotypes were identified within follicular fluid: Phenotype 1 (primary antioxidant defense) and Phenotype 2 (secondary detoxification pathways).
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).
Interpretation:
The follicular redox environment demonstrates a polarized biochemical architecture influenced by BMI and idiopathic infertility, suggesting a shared pathophysiological mechanism affecting the antioxidant network.
Conclusion:
The findings challenge the single-biomarker paradigm in reproductive oxidative stress research, indicating a need for a system-level understanding of oxidative processes in follicular fluid.
