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Evaluating the Therapeutic Potential of Antioxidants in Polyendocrine Metabolic Ovarian Syndrome (PMOS)-Associated Infertility

Mahapatra PD, Bhat VV, Vyas NA, Dharmadhikari S, Puppalwar G, Khandhedia C, Mane A, Mehta S

International journal of women's health, 2026

Abstract

Introduction: Polyendocrine Metabolic Ovarian syndrome (PMOS) formerly known as polycystic ovarian syndrome (PCOS) constitutes the most common endocrinopathy in women of reproductive age group. Evidence from numerous studies in PMOS patients suggests that antioxidants can modulate the ovarian microenvironment, promote folliculogenesis, and increase oocyte competence and yield. This review aims to summarize the existing clinical evidence regarding the application of antioxidants as adjunctive treatment options in the management of PMOS-related infertility.

Materials and methods: This is a structured narrative review. A literature search (1990-2024) was conducted through PubMed, Google Scholar, and Cochrane Library to identify clinical trials evaluating the role of antioxidants specifically Coenzyme Q10 (CoQ10), N-acetylcysteine (NAC), melatonin, and astaxanthin (AST) in PMOS. Studies were identified and screened based on the predefined eligibility criteria. Inclusion criteria were full-text, English-language studies assessing antioxidant interventions in PMOS or related mechanisms; exclusions were reviews, meta-analyses, animal studies, duplicates, and non-English articles. Of 198 records screened, 28 studies met eligibility criteria and were included in this review.

Results: Based on the data included in our review, the available evidence suggests that CoQ10 enhances mitochondrial function and reduces oxidative stress (OS). It has been reported to increase clinical pregnancy…

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