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International Journal of Medical Sciences And Clinical Research

Peer Reviewed | Open Access | E-ISSN: 2771-2265
Published Article

The Significance of The Integrated Oxidative Stress Index in Detecting Subclinical Folliculogenesis Disorders

The Significance of The Integrated Oxidative Stress Index in Detecting Subclinical Folliculogenesis Disorders

Authors

  • Farkhad I.Shukurov
    MD, DSc, Head of the Department of Obstetrics, Gynecology and Reproductology, Tashkent State Medical University, Uzbekistan
  • Mukhayo A. Akhmadjonova
    2nd-year master’s student, Tashkent State Medical University, Tashkent, Uzbekistan

DOI:

https://doi.org/10.37547/ijmscr/Volume06Issue05-29

Keywords:

Folliculogenesis subclinical disorders oxidative stress

Abstract

Objective. To evaluate the diagnostic and prognostic significance of the integrated oxidative stress index in detecting subclinical folliculogenesis disorders in women of reproductive age.

Materials and methods. The study included 90 women of reproductive age, aged 25–40 years. Participants were divided into three groups according to the level of oxidative stress: Group I included women with a high level of oxidative stress (n=30), Group II included women with low or moderate oxidative stress (n=30), and the control group included healthy women with preserved reproductive function and a regular menstrual cycle (n=30). Serum levels of malondialdehyde (MDA), superoxide dismutase (SOD), catalase, and total antioxidant activity were assessed. The integrated oxidative stress index (IOSI) was calculated as the ratio of MDA to total antioxidant activity. Ovarian reserve was assessed using anti-Müllerian hormone (AMH), antral follicle count (AFC), dominant follicle diameter, and signs of ovulation.

Results. In Group I, the MDA level was 5.82±0.43 nmol/mL, which was significantly higher than in Group II and the control group (p<0.001). In the same group, SOD was 31.6±4.8 U/mL, catalase was 23.4±3.7 U/mL, and total antioxidant activity was 0.72±0.09 conventional units. The IOSI was 8.08±1.24 in Group I, 3.54±0.58 in Group II, and 1.77±0.32 in the control group (p<0.001). In Group I, AMH was 1.18±0.32 ng/mL, AFC was 4.7±1.3, and dominant follicle diameter was 14.6±2.1 mm. The IOSI showed significant inverse correlations with AMH (r=-0.62; p<0.001), AFC (r=-0.67; p<0.001), and dominant follicle diameter (r=-0.58; p<0.001). An IOSI value >4.65 was considered an important laboratory criterion indicating a high risk of subclinical folliculogenesis disorders. ROC analysis demonstrated good diagnostic performance of IOSI in detecting subclinical folliculogenesis disorders, with an AUC of 0.86, sensitivity of 80.0%, and specificity of 83.3%. The combined model including IOSI, AMH, and AFC showed the highest diagnostic accuracy, with an AUC of 0.92, sensitivity of 86.7%, and specificity of 88.3%.

Conclusion. The integrated oxidative stress index is a significant laboratory prognostic marker for the early detection of subclinical folliculogenesis disorders. Combined assessment of IOSI, AMH, AFC, and echographic parameters of folliculogenesis enables early identification of the risk of decreased ovarian reserve and ovulatory dysfunction in women of reproductive age.

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