Iron: A double-edged sword of female reproductive health

Iron is an essential micronutrient element for human. It participates in energy metabolism, enzyme activation, immune system and other metabolic functions. In this review, the potential role of iron in female reproductive health were considered. The effects of iron on female reproduction in this review are divided into two aspects: the effects of iron deficiency and iron overload. Iron deficiency and iron overload can affect the health of pregnant women and their babies. It will be discussed from three aspects, namely pregnant woman's health, fetal development and placental function. During iron overload, the increase of reactive oxygen species (ROS) and lipid peroxidation can damage female germ cells and tissues. Ferroptosis is a novel form of cell death that distinguishes apoptosis, autophagy and necrosis. It is dependent on iron overload and lipid peroxidation. It is currently a research hotspot. It has been shown that ferroptosis is associated with many female reproductive disease like polycystic ovary syndrome (PCOS), endometriosis (EMs), endometrial cancer (EC), ovarian cancer (OC) and premature ovarian failure (POF), which in turn to lead female infertility. However, the mechanism of this process is not fully understood. In this review, the occurrence mechanism of ferroptosis and the relationship between ferroptosis and these female reproductive disease will also be discussed. In a word, this review focuses on the effects of iron deficiency and iron overload on female reproduction, and the purpose of this review is to provide a reference for treatment of female reproductive disease.