Molecular Crosstalk between Redox Enzymes, Oxidative Stress, Hormonal Dysregulation, and Pregnancy Loss in Polycystic Ovary Syndrome

Abstract

Background: Polycystic ovary syndrome (PCOS) is a heterogeneous disorder that influences both reproductive and metabolic health in women and is widely recognized as a major contributor to female infertility. Oxidative stress develops when the generation of reactive oxygen species exceeds the capacity of antioxidant defense systems to maintain cellular balance. In pregnancy, the placenta is considered one of the primary sources of oxidative activity, whereas antioxidant mechanisms increase as a protective physiological response against cellular injury. Objectives: The study aims to determine the molecular interaction between oxidation-reduction enzymes and oxidative stress by measuring methionine sulfoxide reductase A, catalase, glutathione S-transferase, xanthine oxidase, myeloperoxidase, methionine adenosyl transferase, and aminoacylase-3 and their relationship to hormonal disorders and miscarriages in patients with polycystic ovary syndrome. Methods: The research was performed in Mosul and included serum specimens obtained from 60 women with polycystic ovary syndrome together with 50 healthy control subjects. Results: These data indicate that PCOS is underpinned by a shared metabolic etiology, defined by chronic oxidative stress and a marked redox imbalance. These findings reinforce the classification of PCOS within a continuum of metabolic pathologies intrinsically linked to insulin resistance and systemic inflammation. Conclusion: PCOS exhibits a complex pathophysiology characterized by the partial, yet insufficient, upregulation of antioxidant defenses, a failure to mitigate persistent oxidative damage. This study underscores the critical influence of the hormonal milieu in modulating these enzymatic and biochemical profiles. Furthermore, the correlation between oxidative imbalance and adverse clinical outcomes, such as miscarriage, highlights the potential of these markers as prognostic indicators for disease progression and long-term complications.