Women infertility is a common reproductive system disorder. Diagnosis and treatment are characterized by limited availability and high costs. This paper intends to evaluate the levels of endogenous antioxidant proteins metallothionein 2 (MT2) and metallothionein 4 (MT4) in the serum of both infertile and fertile women, as well as to assess the association between these proteins and total oxidant capacity (TOC), total antioxidant capacity (TAC), oxidative stress index (OSI), serum anti-Müllerian hormone (AMH), and serum testosterone. This case-control study involved one hundred eighty Iraqi women, categorized into three categories: primary infertile women (P group), secondary infertile women (S group), and healthy fertile women (C group). With regard to the control group, the results demonstrated a significant rise in serum MT2 levels within the primary infertile group, while serum MT4 level displayed a noticeable decrease in the infertile groups. The rise in MT2 could serve as a means to compensate for a decline in MT4, pointing out the potential antioxidant contribution of these proteins in the progression of infertility. A receiver operating characteristic (ROC) outcome demonstrated excellent sensitivity and specificity, alongside an elevated AUC for MT2, MT4, and other biomarkers in a diagnosis of women infertility.
