Summary:
Infertility, defined as the inability to conceive after 12 months of regular, unprotected intercourse, affects around 12-15% of couples worldwide and has been steadily increasing. This condition not only impacts reproductive health but may also elevate the risk of metabolic disorders and reproductive cancers. Female infertility arises from multiple causes, including ovulatory dysfunction, endometriosis, and unexplained factors. Alongside medical conditions, lifestyle and environmental factors are increasingly recognized as contributors, often acting through oxidative stress pathways. Oxidative stress results from an imbalance between reactive oxygen species and the body’s antioxidant defenses, and is implicated in a range of chronic diseases including cardiovascular disease, diabetes, and kidney disease. The Oxidative Balance Score (OBS) was developed to evaluate an individual’s overall oxidative and antioxidant status by integrating dietary and lifestyle factors, such as diet quality, physical activity, BMI, alcohol intake, and smoking. This study used data from the National Health and Nutrition Examination Survey (NHANES) to investigate the association between OBS and female infertility. A total of 3,905 women were included. Infertile participants had significantly lower OBS than fertile women, including lower dietary and lifestyle scores. Increases in OBS lifestyle and dietary scores were associated with reductions in infertility risk. Subgroup analyses suggested that women with no prior pregnancies benefited most from higher OBS, particularly lifestyle-related components. These findings suggest that better oxidative balance, as reflected in higher OBS, is associated with lower risk of female infertility. Strategies to improve antioxidant intake through diet and lifestyle may therefore help reduce infertility risk.
Abstract:
Background: Diet, lifestyle, and oxidative stress have been linked to female infertility, with the Oxidative Balance Score (OBS) serving as a comprehensive indicator of an individual’s oxidative and antioxidant status. This study aims to investigate the correlation between OBS and female infertility. Methods: The National Health and Nutrition Examination Survey (NHANES) from 2013 to 2020 were utilized. Weighted multivariate regression analyses and restricted cubic splines (RCS) were employed to analysis. Additionally, subgroup analyses and multiple imputat6ions (MI) were carried out as sensitivity analyses to ensure the strength and reliability of the findings. Results: A total of 3,905 individuals were involved in the study, the prevalence of female infertility was 11.96%. Individuals with infertility exhibited significantly lower OBS compared to those with normal fertility (19.74 ± 0.37 vs. 21.42 ± 0.20). The OBS dietary and lifestyle components also had lower scores, with averages of 15.98 ± 0.33 vs. 17.12 ± 0.18 and 3.76 ± 0.11 vs. 4.29 ± 0.05, respectively. Weighted logistic regression results revealed that a one-point increase in OBS score was associated with a 3% decrease in infertility risk (Odds Ratio (OR) 0.97, 95% Confidence Interval (CI): 0.95, 0.99). Similarly, a one-point increase in OBS lifestyle score was linked to a 15% decrease in infertility risk (OR: 0.85, 95% CI: 0.75, 0.96), and a one-point increase in OBS dietary score was associated with a 2% decrease in infertility risk (OR: 0.98, 95% CI: 0.96, 0.99). Subgroup analyses revealed that individuals with no prior history of pregnancy benefited more from OBS and OBS lifestyle in terms of infertility risk reduction compared to those with a history of pregnancy. Conclusion: OBS is found to have a negative correlation with infertility, particularly in cases of primary infertility. The results of this study indicate that adopting an antioxidant-rich diet and lifestyle could potentially lower the risk of infertility.
Article Publication Date: 19/06/2025
DOI: 10.3389/fendo.2025.1444832
