CHRONIC INFLAMMATION AND OXIDATIVE STRES

Xolboyeva Mashhura
2026 · doi:10.5281/zenodo.23439562 · W7222830287
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This integrative narrative review examines endometriosis-associated infertility mechanisms and evaluates real-world analytics to improve clinical decision-making while addressing biomarker validity concerns.

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This narrative review integrates mechanistic and clinical evidence to examine the role of chronic inflammation and oxidative stress in endometriosis-associated infertility. The authors analyze distorted pelvic anatomy, immune dysregulation, iron-dependent injury, and altered peritoneal environments while critically evaluating the validity of candidate biomarkers through real-world analytics and artificial intelligence frameworks. The paper prioritizes the 2022 ESHRE endometriosis guideline alongside recent systematic reviews and randomized trials to assess how these factors interact with endometrial receptivity and follicular health. This paper is centrally about endometriosis — specifically the pathophysiological mechanisms of infertility linked to oxidative stress and inflammation.

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Abstract

Endometriosis-associated infertility is a heterogeneous syndrome in which distorted pelvic anatomy interacts with immune dysregulation, iron-dependent oxidative injury, altered follicular and peritoneal environments, and endometrial receptivity. Objective: To critically integrate mechanistic and clinical evidence and examine whether real-world analytics can improve decisions without overstating the validity of candidate biomarkers. Methods: This integrative narrative review prioritizes the 2022 ESHRE endometriosis guideline, recent systematic reviews, randomized trials, and regulatory guidance on real -world evidence and responsible artificial intelligence.
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CHRONIC INFLAMMATION AND OXIDATIVE STRES Authors/Creators Description Endometriosis-associated infertility is a heterogeneous syndrome in which distorted pelvic anatomy interacts with immune dysregulation, iron-dependent oxidative injury, altered follicular and peritoneal environments, and endometrial receptivity. Objective: To critically integrate mechanistic and clinical evidence and examine whether real-world analytics can improve decisions without overstating the validity of candidate biomarkers. Methods: This integrative narrative review prioritizes the 2022 ESHRE endometriosis guideline, recent systematic reviews, randomized trials, and regulatory guidance on real -world evidence and responsible artificial intelligence. Files Xolboyeva 119-156.pdf Additional details References - 1. Becker CM, Bokor A, Heikinheimo O, et al. ESHRE guideline: endometriosis. Hum Reprod Open. 2022;2022(2):hoac009. doi:10.1093/hropen/hoac009. - 2. European Society of Human Reproduction and Embryology. Endometriosis guideline [Internet]. 2022. Available from: https://www.eshre.eu/Guidelines-andLegal/Guidelines/Endometriosis-guideline - 3. The role of iron in the pathogenesis of endometriosis: a systematic review. Hum Reprod Open. 2023;2023(3):hoad033. Available from: https://academic.oup.com/hropen/article/2023/3/hoad033/7232232 - 4. Ferroptosis and oxidative stress in endometriosis: a systematic review of the literature. 2024. PubMed PMID:38489713. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10939684/ - 5. The effects of antioxidant supplementation on pain, oxidative stress markers, and clinical pregnancy rate in women with endometriosis: a systematic review and meta analysis of randomized controlled trials. 2025. PubMed PMID:41234925. Available from: https://pubmed.ncbi.nlm.nih.gov/41234925/

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