Oxidative stress (OS) is a term used to describe the homeostatic oxidation-favoring imbalance between the formation of reactive oxygen species (ROS) or other compounds causing oxidative stress and the countering activities/levels of enzymatic or non-enzymatic antioxidants. The role of OS in reproduction cannot be underestimated in neither health nor disease. This chapter focuses on the roles of OS in spermatogenesis, steroidogenesis and male sexual activity, and also its effects in female folliculogenesis, steroidogenesis, ovulation, luteogenesis, and pregnancy. Furthermore, OS’s impact on the efficacy of Artificial Reproductive Techniques (ARTs) was assessed, and the impact of antioxidants on reproductive health and sterility were discussed in both males and females. Through available evidence, it appears that oxidative state impairs reproductive processes and causes general disruptions through inflammation, DNA damage, lipid peroxidation, protein alterations and mitochondrial dysfunction. It will be of importance to identify oxidative stress biomarkers specific for each reproductive process, and it seems that more research should be focused on epigenetic characteristics together with oxidative stress in reproductive health and infertility.
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