Body mass index as a key determinant of oxidative stress in women undergoing infertility treatment

Introduction Infertility treatment may be influenced by systemic metabolic and redox imbalances. This prospective observational (cross-sectional) study aimed to evaluate the impact of clinical risk factors on oxidative stress markers and components of the antioxidant defence system in women undergoing in vitro fertilization. Methods To capture complex redox interactions, we applied a triad-based analytical framework to assess relationships between clinical variables and oxidative stress–related biomarkers. Results The results indicate that body mass index (BMI) is the strongest determinant of redox imbalance among the analyzed risk factors. Increasing BMI, particularly in the overweight and obese ranges, was associated with a shift toward a pro-oxidative state, as reflected by reduced superoxide dismutase (SOD) activity, alterations in SOD isoenzyme activity, increased lipid peroxidation, and decreased total antioxidant capacity. None of the other evaluated risk factors demonstrated similarly consistent associations with the oxidative stress biomarker panel. Discussion The applied statistical modeling approach enabled the identification of potential cause–and–effect relationships between infertility risk factors and oxidative stress–related biomarkers, identifying BMI as a key modifiable determinant of redox homeostasis, with antioxidant enzymes playing a central role.