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Oxidative stress, generated by activated immune cells, produces reactive oxygen species (ROS) and nitric oxide, causing DNA damage in gametes and embryos, reducing sperm motility, and impairing fertilization ( 2.3 Oxidative stress and ferroptosis in endometriosis Ferroptosis, a novel iron-dependent programmed cell death characterized by the accumulation of lipid peroxides, is distinct from apoptosis, necrosis, and autophagy, and has been closely linked to female infertility, including endometriosis-associated infertility ( 2+ + H 2 O 2 Fe 3+ + OH + OH), producing highly toxic hydroxyl radicals that target lipids, proteins, and nucleic acids, thereby exacerbating oxidative stress