Oxidative Stress and Male Infertility: The Protective Role of Antioxidants

Hyperbaric oxygen therapy for male infertility: a systematic review and meta-analysis on improving sperm quality and fertility outcomes

Hyperbaric oxygen therapy has emerged as a potential adjunctive treatment for male infertility, as it targets various sperm abnormalities and improves fertility outcomes. This systematic review and meta-analysis synthesized data from randomized controlled trials to evaluate the efficacy of hyperbaric oxygen therapy in treating male infertility. A comprehensive literature search identified nine eligible studies, which were assessed for quality using the Jadad scale and analyzed for heterogeneity. The meta-analysis revealed significant improvements in sperm survival, density, morphology, normal sperm rates, and motility following hyperbaric oxygen therapy, with an increased clinical pregnancy rate. Subgroup analyses based on infertility etiology and treatment duration further elucidated the heterogeneity of male infertility stemming from the etiology of infertility. Despite the high robustness of the meta-analysis results, the study is limited by the small number of included trials and potential publication bias. In conclusion, when combined with conventional treatments, hyperbaric oxygen therapy significantly enhances sperm parameters and fertility, underscoring its role as an effective adjunctive therapy for male infertility.

Protective Effect of Cinnamon (Cinnamomum zeylanicum) Extract on the Sperm Quality During Cool Storage of Ram Semen

BACKGROUND

Oxidative stress, caused by an imbalance between reactive oxygen species (ROS) and antioxidants, poses a significant threat to sperm quality during storage.

OBJECTIVE

This study aimed to evaluate the protective effects of cinnamon extract, a natural antioxidant, on ram sperm quality during liquid storage at 4°C.

METHODS

Semen samples from 10 rams were collected, diluted and divided into five treatment groups. Each group received different concentrations of cinnamon extract (0, 50, 100, 150 and 200 µL/mL) added to the diluted semen. Sperm quality was evaluated at storage intervals of 1, 24, 48 and 72 h, with all samples maintained at 4°C during the storage period.

RESULTS

This study demonstrated that cinnamon extract significantly enhances ram sperm quality during liquid storage at 4°C. Notably, the addition of cinnamon extract, particularly at a concentration of 100 µL/mL, resulted in substantial improvements in progressive motility, total motility, sperm viability and plasma membrane integrity over the storage period. Specifically, after 1 h, the 50 µL/mL group showed a significant increase in progressive motility. At 24 h, both total and progressive motility were significantly higher in the 50, 100 and 150 µL/mL groups. By 48 h, the 50 and 100 µL/mL groups demonstrated significant enhancements in all measured parameters. The optimal results were observed at 72 h, where the 100 µL/mL group exhibited the highest values across all sperm quality metrics. These findings underscore the effectiveness of cinnamon extract as a natural antioxidant for preserving sperm quality during storage.

CONCLUSIONS

Supplementation with cinnamon extract significantly enhances ram sperm quality, with an optimal concentration of 100 µL/mL effectively maintaining sperm viability during 72 h of liquid storage. These results suggest that cinnamon extract may serve as a valuable natural antioxidant for improving sperm preservation in liquid storage conditions.

Insulin‑like growth factor 2 in spermatogenesis dysfunction (Review)

Spermatogenesis dysfunction is characterized by abnormal morphology, destruction, atrophy of seminiferous tubules, blocked differentiation of spermatogenic cells, decreased sperm count and increased sperm abnormalities. Inflammation, oxidative stress, endoplasmic reticulum stress and obesity are important factors leading to spermatogenesis dysfunction. It has been demonstrated that insulin‑like growth factor 2 (IGF2) is closely related to the aforementioned factors. In the present review, the relationship between IGF2 and inflammation, oxidative stress, ER stress and obesity was investigated, providing theoretical and experimental evidence on the role of IGF2 in the prevention and treatment of spermatogenesis dysfunction of male infertility.

Relationship between male infertility and hematological parameters in patients with thalassemia minor

BACKGROUND

There is no research explaining the relationship between thalassemia minor and male infertility.

OBJECTIVE

The aim of this study was to investigate the relationship between male infertility and hematological parameters in patients with thalassemia minor.

MATERIALS AND METHODS

The patients who were identified as thalassemia carriers during premarital thalassemia screening tests performed at the Public Health Laboratory between 2021 and 2023 were evaluated. The patients with normal semen parameters were assigned to the first group, while those with abnormal semen parameters (oligozoospermia, asthenozoospermia, teratozoospermia, and azoospermia) comprised the second group. The hematologic parameters and hormonal parameters values were examined.

RESULTS

The mean age of the patients was 31 (21-43) years. A total of 49 patients with thalassemia minor were included in the study. Of these, 39 had abnormal semen parameters and 10 had normal semen parameters. Among the patients, 8 (16%) had azoospermia, 6 (12%) had oligozoospermia, 9 (18%) had teratozoospermia, and 16 (32%) had asthenozoospermia. The Mean Corpuscular Hemoglobin Concentration (MCHC) values were significantly lower in patients with abnormal semen parameters (p = 0.01). According to the regression analysis, Mean Corpuscular Volume (MCV) increased the likelihood of deteriorating semen parameters by 0.88-fold, while MCHC increased it by 2.64-fold.

CONCLUSION

Deterioration in sperm parameters was observed in men with thalassemia minor, and hematological parameters-particularly MCHC and MCV-were identified as potential risk factors for infertility. These findings underscore the importance of considering hematological parameters when evaluating fertility in men with thalassemia minor. Infertility is multifactorial and other mechanisms such as oxidative stress and inflammation should also be evaluated.

From infection to infertility: a review of the role of human papillomavirus-induced oxidative stress on reproductive health and infertility

Infertility has emerged as a significant global health concern, affecting nearby 8-12% of couples in reproductive age worldwide. Increasing evidence suggests a potential link between human papillomavirus (HPV) and infertility in both men and women. Some research indicate that HPV can infect various components of semen, potentially affecting sperm quality by decreasing motility, viability, and increasing DNA fragmentation, all of which may contribute to male infertility. The virus can attach to the equatorial region of the sperm head, enabling infected sperm to transmit the virus to the oocyte or placenta. Consequently, HPV potentially induces apoptosis in trophoblastic cells and disrupts their adhesion to endometrial cells, which raises the risk of miscarriage. HPV may also affect ovarian reserve by causing chronic inflammation, which can impair granulosa cell function and lower serum anti-Müllerian hormone (AMH) levels. Besides, HPV-related immune responses also contribute to infertility by producing anti-sperm antibodies (ASAs), which cause sperm clumping, reduce motility through cervical mucus, activate the complement system that damages sperm in the female reproductive tract and interfere with sperm-egg interactions. Moreover, HPV infection has been linked to reduced success rates in assisted reproductive technologies (ART), potentially disrupting critical processes such as the acrosome reaction, sperm-oocyte interaction, and fusion. One potential mechanism through which HPV contributes to infertility is oxidative stress (OS). Triggered OS can negatively impact sperm quality and cause damage to the female reproductive system, ultimately contributing to infertility. Despite these associations, the precise mechanisms and the strength of the relationship remain uncertain. Thus, this review seeks to investigate the potential impact of HPV on infertility, particularly its effects on the reproductive system through OS. A clearer understanding of these processes could inform future health strategies for addressing HPV-related infertility.

Protective effects of wheat sprout extract on acrylamide-induced toxicity in testis, prostate gland and sperm parameters of rats

Acrylamide (ACR) is a harmful compound that forms in food cooked at high temperatures, influenced by food type, preparation methods, temperature, and cooking time. Recent studies have indicated that ACR adversely affects male reproductive system and sperm health, primarily through oxidative stress. Wheat sprout (WS) is a unique medicinal plant that contains a high number of antioxidants. The main objective of this study was to investigate the possible effects of WS treatment on histological, biochemical and immunohistochemical changes in the testis and prostate as well as on the sperm parameters of rats exposed to ACR. Twenty adult male rats were split into four groups. One group received 1 mL normal saline, another group received 50 mg/kg ACR, third group received 200 mg/kg WS and fourth group received a combination of ACR (50 mg/kg) and WS (200 mg/kg). After 21 days, the epididymis was immediately examined for assessment of sperm. The prostate and left testis were placed in 10% formalin for histomorphometric and immunohistochemical analyses. The right testes were removed to measure testosterone, malondialdehyde (MDA) and total antioxidant capacity (TAC) levels. ACR consumption significantly decreased sperm count, viability, motility, and DNA fragmentation, whereas WS intake significantly improved these sperm parameters (p < 0.05). Compared with ACR, WS enhanced spermatogenesis indices, including TDI- and SI-positive seminiferous tubules, Johnson score, testis weight, body weight, and relative weight (p < 0.05). Furthermore, WS significantly reduced p53 expression and increased Bcl-2 expression, thereby counteracting ACR-induced apoptosis. The findings suggest that WS may effectively enhance and restore the histomorphometric, cellular, and hormonal changes in the male reproductive system caused by ACR.

Vitamin D alleviates chronic stress-induced testicular steroidogenesis disruption in Wistar rats

Stress is associated with various health issues. Research has highlighted the relationship between chronic stress and male reproductive health. One of the primary mechanisms underlying stress-induced male reproductive dysfunction is impaired steroidogenesis. In the present study, we validated a chronic unpredictable stress (CUS) model and investigated testicular dysfunction in CUS rats. The CUS paradigm involved exposing rats to a variety of stressors daily for 8 weeks. Vitamin D (10 µg/kg/twice a week, p.o) was administered to CUS rats starting 2 weeks after the onset of stress exposure and continued until the end of study. The stress in rats was confirmed by the occurrence of anxiety and depressive-like behaviours through elevated plus-maze test & novelty-suppressed feeding test and rise in serum corticosterone levels. Testicular dysfunction in CUS rats was assessed via serum gonadotropins, testosterone, cytokines, oxidative stress, and testis-epididymis-sperm morphology. The reduction in steroidogenesis was confirmed via immunohistochemical analysis of 17β-hydroxysteroid dehydrogenase-3 (17β-HSD3), steroidogenic acute regulatory gene (StAR) and vitamin D receptor (VDR) expression. Further, we studied the role of vitamin D in alleviating stress-induced testicular damage and the potential mechanisms underlying steroidogenic alterations in CUS rats. Notably, vitamin D treatment prevented CUS-induced decline in testicular 17β-HSD3, StAR and VDR expression. Moreover, vitamin D ameliorated the CUS-induced reduction in serum testosterone levels. Histological assessment revealed that vitamin D prevented CUS-induced damage in sperm, testis and epididymis morphology. In conclusion, our findings suggest that CUS exposure induces testicular dysfunction, which can be prevented by vitamin D, potentially through the regulation of steroidogenic pathways.

Impact of the Environmental Endocrine Disruptor 4-Octylphenol on Reproductive Function in Pubertal Male Mice

4-Octylphenol, a major environmental degradation product of alkylphenols (Aps) used in industry, is an endocrine-disrupting chemical with significant estrogenic activity. It is one of the most toxic Aps, poorly biodegradable in the environment, and can accumulate in organisms through the food chain, thereby affecting the male reproductive system. In this study, the effect of 4-octylphenol on male reproductive health was analyzed. Male pubertal mice were exposed to 4-octylphenol at doses of 0, 1, 10, and 100 mg/kg once daily for 28 days. Our findings indicated that pubertal exposure to 4-octylphenol has significant negative effects on the male reproductive system. Pubertal mice exposed to 4-octylphenol exhibited dose-dependent reproductive toxicity. In the medium- and high-dose groups, a significant reduction in testicular mass, structural damage to the seminiferous tubules, increased oxidative stress and apoptosis within the testicular tissue, and a decline in sperm quality were observed. Additionally, autophagy processes in the testicular tissue, germ cell proliferation, and meiotic processes are inhibited. Serum testosterone and estradiol levels decreased, whereas oxidative stress levels in the testes and spermatozoa increased. In contrast, the low-dose group showed only a reduction in body weight, a decrease in motile sperm count, and mild oxidative stress in the testes without significant pathological changes in western blot experiments. These results indicate that 4-octylphenol exposure during puberty caused reproductive toxicity in male mice.

The Nexus Between Sperm Membrane Integrity, Sperm Motility, and DNA Fragmentation

This study investigated the interrelationships between sperm plasma membrane integrity, motility, and DNA fragmentation (SDF) to provide a more holistic understanding of male fertility. A total of 1159 ejaculates were analyzed for sperm membrane integrity (% dead spermatozoa), motility (% immotile spermatozoa), and SDF (% sperm with fragmented DNA). The statistical methods included non-parametric correlation analysis and artificial intelligence (AI)-generated cluster analysis to identify patterns based on these three parameters. The results showed a moderate correlation (ρ = 0.65; p < 0.000) between sperm membrane integrity and motility, indicating that immotile sperm were more likely to exhibit membrane damage. A weak correlation (ρ = 0.21; p < 0.000) suggested that DNA damage was largely independent of the other sperm parameters. Cluster analysis identified three main clusters: Cluster 0: high levels of low membrane integrity, immotile sperm, and moderate DNA fragmentation. Cluster 1: moderate membrane integrity and motility but extremely high DNA fragmentation. Cluster 2: the lowest levels of membrane damage, immotile sperm, and DNA fragmentation, indicating overall better sperm quality. The clustering techniques demonstrated their ability to integrate multiple sperm parameters, enabling a more individualized fertility diagnosis and potentially enhancing male infertility assessments.

Mitochondrial specific antioxidant MitoPBN mitigates oxidative stress and improves mitochondrial function in cryopreserved ram sperm

Oxidative stress impairs sperm function and fertility in rams, most notably during cryopreservation, and is characterized by compromised sperm function and motility. Mitochondria contribute immensely towards sperm function, such as mitochondrial membrane potential (MMP) which is crucial for ATP production. The purpose of this study was to assess the role of MitoPBN supplementation on cryopreserved sperm quality in mature Ghezel ram sperm. Semen samples were treated with 0 (control), 100, 150, 200, and 250 µmol/L MitoPBN and then analyzed for key sperm factors. Results indicated that supplementation with 100 and 150 µmol/L MitoPBN significantly enhanced total motility, increasing to 52.36 ± 4.26% and 54.16 ± 3.19%, respectively. Progressive motility similarly improved to 24.82 ± 3.27% and 26.77 ± 3.46%, respectively. Additionally, sperm membrane integrity was markedly increased to 50.01 ± 4.22% and 52.54 ± 2.24%, while mitochondrial activity was significantly augmented from 35.14 ± 4.09% to 46.16 ± 4.02% and 50.26 ± 6.69%. Sperm viability also improved, rising to 48.99 ± 3.98% and 52.20 ± 3.17%, respectively. Notably, reactive oxygen species (ROS) levels were reduced to 2.95 ± 0.16% and 2.80 ± 0.11%, respectively, paralleled by enhancements in total antioxidant capacity (TAC; 1.85 ± 0.21% and 1.93 ± 0.16%, respectively) and glutathione peroxidase (GPx) activity (61.16 ± 4.77% and 63.36 ± 4.95%, respectively). Moreover, ATP content reached a peak of 116.29 ± 5.83 in the 150 µmol/L group. In conclusion, our results evidence that oxidative stress during ram sperm cryopreservation is effectively countered by MitoPBN, improving sperm quality.

Protective Role of Physical Activity and Antioxidant Systems During Spermatogenesis

Oxidative stress is a significant factor that contributes to male infertility and sperm dysfunction. In this condition, an increase in ROS production exceeds the body's antioxidant defenses, resulting in a decline in spermatozoa quality and fertilizing capacity. Furthermore, excessive ROS production has been linked to the promotion of genomic damage, lipid peroxidation, inflammation, altered enzyme activity, and ultimately, irreversible alterations, cell death, and a decline in seminal parameters associated with male infertility. It is established that physical activity (PA), acting on inflammatory parameters and improving antioxidant defense, can alleviate the negative effects caused by free radicals, offering numerous health benefits and positively influencing sperm quality. The objective of this review is to highlight the mechanisms of ROS production, the physiological and pathophysiological roles of ROS in relation to the male reproductive system, and recent knowledge on the impact of some protocols of PA on these systems and the molecular mechanisms involved.

Cell protective effects of vitamin C against oxidative stress induced by ciprofloxacin on spermatogenesis: involvement of cellular apoptosis

Introduction

Ciprofloxacin (CPFX), a second-generation fluoroquinolone, is widely used as an anti-infective agent for genitourinary tract infections due to its broad-spectrum efficacy against gram-positive and gram-negative organisms. Although CPFX is considered safe at therapeutic doses, recent evidence suggests its potential biological toxicity, particularly affecting testicular histology and function. This study aimed to investigate the effects of CPFX on testicular structure and function and to evaluate the protective role of vitamin C.

Methods

Forty adult male albino rats were divided into four groups: control, CPFX-treated, vitamin C-treated, and CPFX combined with vitamin C-treated. After 60 days of treatment, blood samples were collected for hormonal assays, while testicular and epididymal tissues were analyzed using light and electron microscopy. Oxidative stress markers, including malondialdehyde (MDA), glutathione (GSH), and catalase (CAT) enzyme activity, were assessed. Statistical analyses were conducted using SPSS software.

Results

Confocal microscopy of the CPFX-treated group revealed significant reductions in germ cell populations within seminiferous tubules, accompanied by severe apoptosis and degenerative epithelial changes. Morphometric analysis confirmed a decrease in tubular diameter and epithelial height, degeneration of spermatogenic cells, and detachment of apoptotic cells from the basement membrane. CPFX treatment significantly reduced testosterone levels and induced variable changes in gonadotropin hormones (LH and FSH). Co-administration of vitamin C with CPFX restored normal testicular morphology, preserving seminiferous tubule integrity and maintaining spermatogenic cell populations and spermatozoa within the lumen.

Discussion and Conclusion

Vitamin C supplementation effectively mitigated CPFX-induced oxidative stress by significantly reducing MDA levels and enhancing antioxidant defenses, including increased GSH content and CAT enzyme activity. These findings highlight the therapeutic potential of vitamin C in reversing CPFX-induced testicular toxicity by alleviating oxidative stress and restoring testicular function.

Evaluation of the Reversibility of Cadmium-Induced Testicular Toxicity Following Recovery Alone or with Zinc Supplementation

Cadmium (Cd) is a toxic heavy metal that disrupts spermatogenesis and steroidogenesis due to its long half-life. This study evaluated the impact of recovery alone or with zinc (Zn) supplementation on Cd-induced testicular toxicity. A total of 42 pubertal male Wistar rats were divided into seven groups of six rats each. The control group (1) received NaCl (0.9%). Groups 2, 3, and 4 were treated with Cd 10 μg/kg/d by intraperitoneal injection for 1, 2, and 3 months respectively. Group 5 received Cd for 3 months with a recovery period of 1 month; Group 6 was exposed to Cd for 3 months, followed by a 1-month recovery period combined with Zn supplementation. (0.5 mg/kg/d). The last group was treated with zinc at a dose of 0.5 mg/kg/day for one month. The results showed decreased body weight, testicular and epididymal weight, testicular dimensions, and sperm parameters, along with Cd accumulation in the testes. Cd caused testicular damage and reduced serum testosterone levels, with more pronounced effects in the 3-month treatment group. Recovery alone did not significantly reverse Cd's toxic effects, whereas Zn supplementation mitigated most of the damage. Recovery combined with Zn supplementation was more effective in correcting Cd-induced testicular toxicity than recovery alone.

Analyzing free fatty acids in seminal plasma from asthenozoospermia patients undergoing antioxidant therapy

OBJECTIVE

Different aspects of the functions of free fatty acid (FFA) in seminal plasma and their implications on male fertility are known. However, the profile of FFA in seminal plasma in asthenozoospermic patients following antioxidant therapy has not been studied.

METHODS

In this case-control study, the total antioxidant capacity (TAC) and FFA profile of the seminal plasma were determined in 80 patients (29 normozoospermic volunteers and 51 asthenozoospermic men) who were treated with antioxidants for three months.

RESULTS

The TAC level in normozoospermic men was significantly higher than in asthenozoospermic men before and after antioxidant therapy with even lower values after the treatment (p=0.0001). The most abundant identified FFAs in seminal plasma were palmitic acid, vaccenic acid, eicosatrienoic acid, stearic acid, and myristoleic acid. Palmitic acid was lower in asthenozoospermic patients (p=0.0001), and antioxidant treatment restored its level to near-control levels. Compared to normozoospermic controls, the level of eicosatrienoic acid is significantly lower in asthenozoospermia patients before (p=0.01) and after treatment (p=0.0001). Additionally, following oral antioxidant supplementation, the FFA pattern in asthenozoospermic patients changes to the pattern observed in normozoospermic men. However, these changes are not statistically significant.

CONCLUSIONS

The TAC level in asthenozoospermic patients after antioxidant treatment did not change to the levels in the control group; it even dropped to a lower level following three months of treatment. Antioxidant treatment can change the level of the FFA compositions of seminal plasma.

Can nutraceuticals counteract the detrimental effects of the environment on male fertility? A parallel systematic review and expert opinion

INTRODUCTION

Male fertility relies on a complex physiology that may be negatively influenced by lifestyle, diet, and environment. The beneficial effect of nutraceuticals on male fertility is a debated claim. The aim of this study was to assess if the positive effect of nutraceuticals can counteract the negative effects of the environment on male fertility.

EVIDENCE ACQUISITION

PubMed®/MEDLINE®, Embase and Cochrane Database were searched (September-October 2023), along with crosschecking of references and search for ongoing studies of the effects of the environment and nutraceuticals on male fertility, in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

EVIDENCE SYNTHESIS

Several environmental factors such as microplastic and other endocrine-disrupting chemicals and climate changes may affect the sperm quality in terms of reduction of sperm count number, mobility and altered morphology and thereby reduce male fertility. On the other hand, new evidence demonstrates that a balanced diet rich in antioxidants and essential nutrients, together with minimized exposure to environmental toxins, may improve male fertility and reproductive health. Several nutraceutical compounds proved a protective role against negative environmental effects on male fertility.

CONCLUSIONS

Available evidence confirms that the environment may negatively impact male fertility, and this impact is estimated to rise in the forthcoming years. On the other hand, new data indicate that nutraceuticals may have a protective role against the negative impact of environmental factors on male fertility. The need for future studies to monitor and explore these aspects of men's health cannot be underestimated.

Dietary Arginine Supplementation Modulates the Proteome of Boar Seminal Plasma

This study investigated the impact of an increased arginine (ARG) level in a boar diet on semen production, sperm quality, and seminal plasma proteome. Adult Nebraska Index Line boars were assigned to two groups, one receiving a control diet with 0.77% arginine (n = 4) and the other a high-arginine diet with 1.77% arginine (n = 5). Semen was collected twice a week over the whole experiment, including one week before, six weeks during, and six weeks after the supplementation. Parameters such as semen volume and concentration were assessed immediately after collection, alongside sperm motility and morphology. Centrifugation of raw semen samples yielded seminal plasma for a gel-based proteome analysis. The seminal plasma proteins were extracted, quantified, and separated via 2D gel electrophoresis, allowing protein identification through mass spectrometry. Data analysis involved two-way ANOVA for comparisons (p < 0.05). Results showed that arginine supplementation improved semen volume and total sperm counts, with averages of 21 ± 3 doses in the control group versus 24 ± 2 in the ARG group (p = 0.05). Although sperm motility and morphology remained unaffected (p > 0.05), dietary arginine upregulated ten proteins and downregulated two. In summary, increased dietary arginine did not significantly alter key parameters of semen output or sperm quality but significantly impacted seminal plasma proteome, warranting further research on sperm viability.

Oxidative Stress in Benign Prostatic Hyperplasia: Mechanisms, Clinical Relevance and Therapeutic Perspectives

BACKGROUND/OBJECTIVES

Benign prostatic hyperplasia (BPH) is among the most common conditions affecting men as they age, resulting in lower urinary tract symptoms (LUTS) that can profoundly impact quality of life. While historically attributed primarily to androgenic imbalances, current evidence implicates additional factors-particularly oxidative stress (OS) and chronic inflammation-in BPH pathogenesis. This review aims to synthesize research on the interplay between OS, inflammation, and hormonal regulation in BPH, emphasizing their clinical relevance and potential therapeutic implications.

METHODS

A comprehensive review of peer-reviewed literature was conducted focusing on mechanistic studies, clinical trials, and observational reports. Searches included data on ROS generation, antioxidant capacity, inflammatory mediators, and their contribution to pathological prostatic overgrowth. Potential interventions targeting OS-such as antioxidant supplementation, anti-inflammatory drugs, vitamin D receptor agonists, and phytotherapeutics-were also evaluated for their efficacy and safety profiles.

RESULTS

Chronic inflammation and OS were consistently identified within hyperplastic prostate tissue. Excessive ROS production, diminished antioxidant defense, and sustained cytokine release create a proproliferative and antiapoptotic environment, accelerating disease progression. Metabolic comorbidities (e.g., obesity, insulin resistance) further exacerbate these imbalances. Standard therapies (α-blockers and 5-ARIs) effectively relieve symptoms but do not directly address the oxidative-inflammatory axis. Emerging evidence suggests that pharmacological and dietary approaches targeting OS and inflammation may reduce prostate volume expansion and alleviate LUTS.

CONCLUSIONS

Findings indicate that OS and inflammation are key contributors to BPH progression. Incorporating antioxidant and anti-inflammatory strategies alongside conventional treatments holds promise for improving clinical outcomes and patient quality of life. Future research should focus on validating OS-specific biomarkers and optimizing personalized therapy regimens.

Protective Effect of Nerolidol on Paclitaxel-Induced Reproductive Toxicity in Rats: Oxidative Stress and Inflammation

Paclitaxel (PAC), derived from Taxus brevifolia, is used to treat solid tumours but causes reproductive toxicity due to oxidative stress, affecting sperm quality and testicular tissue. Nerolidol (NRL), an antioxidant sesquiterpene alcohol, has not been studied for its potential to reduce PAC-induced reproductive damage. This study investigates NRL's ability to mitigate PAC-induced reproductive toxicity in rats. Forty healthy adult male Spraque Dawley rats were randomly divided into four equal groups (Control, PAC, NRL, PAC + NRL). PAC was given intraperitoneally at a dose of 2 mg/kg once a week for 4 weeks. NRL was given orally at a dose of 100 mg/kg/day for 4 weeks. Control group received PAC and NRL vehicles. After 4 weeks, testis tissue samples were collected, and parameters, including oxidants, antioxidants, sperm motility, density, abnormal spermatozoon ratios and cytokines, were measured. PAC administration increased oxidant levels and decreased antioxidant enzyme activities. Nerolidol mitigated these alterations significantly. Similarly, PAC elevated IL-1, IL-6, TNF-α levels and lowered IL-10 levels, these effects attenuated by nerolidol in the PAC + NRL group. In conclusion, it was determined that PAC induces reproductive toxicity through oxidative stress, and NRL demonstrates potential in ameliorating these effects through its antioxidant activity.

The association between consumption of ultra-processed foods and sperm quality parameters: a cross-sectional study

BACKGROUND

While recent studies suggest a correlation between unhealthy dietary patterns, oxidative stress, inflammation, and male infertility, the potential association between ultra-processed foods (UPFs) and male infertility remains underexplored. Therefore, the aim of the present study was to investigate the association between UPF intake and male infertility by evaluating sperm quality parameters.

METHODS

The participants (n = 260) of the current cross-sectional study were recruited from an infertility center in Isfahan Province, Iran. Four semen parameters-such as total sperm motility, sperm concentration, sperm volume, and normal sperm morphology-were evaluated. Also, the participants' food intake was assessed using a validated 168-item food frequency questionnaire. Moreover, the NOVA system was employed to calculate the UPF index. The association between UPFs and sperm parameters was analyzed using logistic regression.

RESULTS

In the crude model, no significant associations were observed between the second and last tertiles of UPFs with abnormalities in sperm concentration, total motility, and morphology (p > 0.05 for all). However, after adjusting for age, marriage duration, body mass index, physical activity, depression, anxiety, stress, energy intake, cigarette history, and mineral and vitamin supplements, a significantly higher association was identified between the second tertile of UPFs and abnormalities in sperm concentration (odds ratio (OR) = 3.962, 95% confidence interval (CI): 1.345-11.670, p = 0.013).

CONCLUSIONS

In conclusion, although the analysis did not find significant associations between UPF consumption and impaired sperm motility and morphology, it revealed significant trends linking higher UPF intake with lower sperm concentration. If future studies confirm these results, they could aid in designing interventional and preventive programs aimed at addressing infertility in men of reproductive age in the field of public health.

Association Between Zinc Levels and the Impact of Its Deficiency on Idiopathic Male Infertility: An Up-to-Date Review

BACKGROUND

Zinc (Zn) is an essential metal that plays a critical role in normal testicular development, spermatogenesis, prevention of sperm degradation, and overall male fertility. This review aims to offer a comprehensive and current overview of seminal plasma Zn levels in fertile men worldwide. It also aims to compare Zn levels in seminal plasma and blood (serum/plasma) between infertile men (cases) and fertile men (controls), examine the impact of Zn on sperm quality and the reproductive hormone, and highlight the effects of Zn supplementation therapy in male infertility.

METHODS

To achieve these goals, peer-reviewed studies from 2000 to 2024 were interrogated with regard to strict inclusion/exclusion criteria and were then thoroughly reviewed and analyzed.

RESULTS

Our findings indicate that maintaining optimal seminal plasma Zn levels is crucial, as low Zn levels are linked to impaired spermatogenesis and male infertility, while high Zn levels can cause oxidative stress and other changes that contribute to infertility. Seminal plasma Zn levels from 100 to 200 mg/L among fertile men worldwide can be roughly considered safe. Comparative analysis showed that a greater number of studies reported lower levels of seminal Zn in cases than in controls. Research into the impact of Zn levels in seminal plasma has shown that, although the results are not yet conclusive, altered (non-normal) Zn levels could influence semen parameters-particularly motility, morphology, and sperm count-and the level of the reproductive hormone, testosterone. Zinc-deficient infertile men could benefit from supplement therapy.

CONCLUSIONS

Assessment of seminal plasma Zn levels in infertile men could provide valuable information and aid in diagnosis and treatment planning.

Oxidative-Stress-Mediated Epigenetic Dysregulation in Spermatogenesis: Implications for Male Infertility and Offspring Health

Male reproductive health is governed by an intricate interplay of genetic, epigenetic, and environmental factors. Epigenetic mechanisms-encompassing DNA methylation, histone modifications, and non-coding RNA activity-are crucial both for spermatogenesis and sperm maturation. However, oxidative stress, driven by excessive reactive oxygen species, disrupts these processes, leading to impaired sperm function and male infertility. This disruption extends to epigenetic modifications, resulting in abnormal gene expression and chromatin remodeling that compromise genomic integrity and fertilization potential. Importantly, oxidative-stress-induced epigenetic alterations can be inherited, affecting the health and fertility of offspring and future generations. This review investigates how oxidative stress influences epigenetic regulation in male reproduction by modifying DNA methylation, histone modifications, and non-coding RNAs, ultimately compromising spermatogenesis. Additionally, it discusses the transgenerational implications of these epigenetic disruptions and their potential role in hereditary infertility and disease predisposition. Understanding these mechanisms is vital for developing therapeutic strategies that mitigate oxidative damage and restore epigenetic homeostasis in the male germline. By integrating insights from molecular, clinical, and transgenerational research, this work emphasizes the need for targeted interventions to enhance male reproductive health and prevent adverse outcomes in progeny. Furthermore, elucidating the dose-response relationships between oxidative stress and epigenetic changes remains a critical research priority, informing personalized diagnostics and therapeutic interventions. In this context, future studies should adopt standardized markers of oxidative damage, robust clinical trials, and multi-omic approaches to capture the complexity of epigenetic regulation in spermatogenesis. Such rigorous investigations will ultimately reduce the risk of transgenerational disorders and optimize reproductive health outcomes.

Micronutrient-Antioxidant Therapy and Male Fertility Improvement During ART Cycles

Today, accumulating evidence highlights the impact of oxidative stress (OS) on semen quality. It is considered to be a key factor contributing to the decline in male fertility. OS is detected in 30-80% of men with infertility, highlighting its strong association with impaired reproductive function and with clinical outcomes following the use of assisted reproductive technologies. Spermatozoa are particularly vulnerable to oxidative damage due to their high content of polyunsaturated fatty acids (PUFAs) and limited antioxidant defense abilities. OS arises from an imbalance between the production of reactive oxygen species and the capacity to neutralize or repair their adverse effects. Evidence indicates that OS leads to lipid peroxidation, protein oxidation, mitochondrial dysfunction, and genomic instability. Micronutrient-antioxidant therapies can play a key role in infertility improvement by neutralizing free radicals and preventing cellular damage. Many different micronutrients, including L-carnitine, L-glutathione, coenzyme Q10, selenium, and zinc, as well as vitamins complexes, are proposed to improve sperm parameters and male fertility potential. This study aims to review the impact of antioxidant supplementation on semen parameters, including sperm volume, motility, concentration, morphology, genome integrity (maturity and fragmentation), and in vitro fertilization (IVF) outcomes. Antioxidant intake and a balanced lifestyle reduce oxidative stress and mitochondrial dysfunction, enhancing the spermatogenesis and spermiogenesis processes, improving sperm quality, and protecting DNA integrity.

Detrimental effects of cadmium on male infertility: A review

Infertility has become a serious health and socio-economic-psychological problem globally. The harmful role of trace metals in male infertility is recognized but still not sufficiently explained. Herein, a comprehensive review was conducted to elucidate the detrimental role of cadmium (Cd) on male infertility, particularly on infertility with unknown (idiopathic) causes. Peer-reviewed studies from 2000 to 2024 dealing with seminal plasma and blood Cd levels of fertile and infertile men were retrieved were interrogated with regard to strict inclusion/exclusion criteria, and then were thoroughly reviewed and analyzed. Another aim of this review was to indicate the potential effects of Cd on changes in seminogram findings. A median range of seminal plasma Cd levels from 0.2 to 1.5 µg/L can be considered safe for men's fertility. This review strongly implies that Cd levels were notably higher in seminal plasma of infertile cases than controls. The review's data also indicate that exposure to tobacco smoke is a major source of elevated seminal and blood Cd levels in infertile men. Newer research points to the importance of Cd in lower levels from the environment on changes in seminogram findings, primarily count, motility of spermatozoa, and their morphology. Overall, this review implies that seminal plasma Cd levels could be a good indicator of semen quality. However, new, in-depth studies are needed to confirm or reject the causal relationship of Cd with male infertility.

Comparative Impact of Microsurgical Varicocelectomy Versus Observation on Infertility in Infertile Men With Subclinical Varicocele

PURPOSE

The efficacy of varicocelectomy in treating infertility among men with ultrasonography-detected subclinical varicocele continues to be a topic of clinical uncertainty. This multicentric, prospective, non-randomized study aimed to evaluate the effect of microsurgical ligation of the internal spermatic vein in men with left subclinical varicocele and no other infertility causes.

PATIENTS AND METHODS

The study included 34 infertile men diagnosed with subclinical left varicocele by color Doppler ultrasonography. After a shared decision-making process, the participants self-selected either microsurgical ligation (n = 18) or conservative management (n = 16). Baseline age, duration of infertility, reproductive hormone levels, and semen parameters were comparable across groups. The primary outcomes included changes in sperm concentration, progressive motility, and morphology over a nine-month follow-up period.

RESULTS

After nine months, there were no statistically significant differences between the surgery and observation groups in sperm concentration or progressive motility. After adjusting for baseline values, sperm concentration increased by 3 × 106/mL (95% CI: -6.1 to 12.1), and progressive motility improved by 7.1% (95% CI: -1.3 to 15.5%) post-surgery, although these increases were not significant. However, the surgical group demonstrated a significant 5.6% improvement in sperm morphology (95% CI: 0.1 to 11.2%, p = 0.045) compared to observation.

CONCLUSION

Although this study's small sample size limits its broader generalizability, its findings provide limited evidence that microsurgical ligation may modestly improve sperm morphology in men with subclinical varicocele. Further research with larger, randomized cohorts is warranted to confirm these results and assess potential fertility outcomes.

Alpha-lipoic Acid: An Antioxidant with Anti-aging Properties for Disease Therapy

The anti-aging effects of alpha-lipoic acid (αLA), a natural antioxidant synthesized in human tissues, have attracted a growing interest in recent years. αLA is a short- -chain sulfur-containing fatty acid occurring in the mitochondria of all kinds of eukaryotic cells. Both the oxidized disulfide of αLA and its reduced form (dihydrolipoic acid, DHLA) exhibit prominent antioxidant function. The amount of αLA inside the human body gradually decreases with age resulting in various health disorders. Its lack can be compensated by supplying from external sources such as dietary supplements or medicinal dosage forms. The primary objectives of this study were the analysis of updated information on the latest two-decade research regarding the use of αLA from an anti-aging perspective. The information was collected from PubMed, Wiley Online Library, Scopus, ScienceDirect, SpringerLink, Google Scholar, and clinicaltrials.gov. Numerous in silico, in vitro, in vivo, and clinical studies revealed that αLA shows a protective role in biological systems by direct or indirect reactive oxygen/nitrogen species quenching. αLA demonstrated beneficial properties in the prevention and treatment of many age-related disorders such as neurodegeneration, metabolic disorders, different cancers, nephropathy, infertility, and skin senescence. Its preventive effects in case of Alzheimer's and Parkinson's diseases are of particular interest. Further mechanistic and clinical studies are highly recommended to evaluate the wide spectrum of αLA therapeutic potential that could optimize its dietary intake for prevention and alleviation disorders related to aging.

Impact of Ultraviolet C Radiation on Male Fertility in Rats: Suppression of Autophagy, Stimulation of Gonadotropin-Inhibiting Hormone, and Alteration of miRNAs

While ultraviolet C (UVC) radiation has beneficial applications, it can also pose risks to living organisms. Nevertheless, a detailed assessment of UVC radiation's effects on mammalian male reproductive physiology, including the underlying mechanisms and potential protective strategies, has not yet been accomplished. This study aimed to examine the critical roles of oxidative stress, autophagy, reproductive hormonal axis, and microRNAs in UVC-induced reproductive challenges in male rats. Semen, biochemical, molecular, and in silico analyses revealed significant dysregulation of testicular steroidogenesis, impaired spermatogenesis, deteriorated sperm quality, and altered reproductive hormonal profiles, which ultimately lead to a decline in fertility in male rats exposed to UVC radiation. Our data indicated that the suppression of autophagy, stimulation of gonadotropin-inhibiting hormone (GnIH), and alteration of microRNAs serve as key mediators of UVC-induced stress effects in mammalian reproduction, potentially contributing to male infertility. Targeting these pathways, particularly through pretreatment with hesperidin (HES), offers a promising strategy to counteract UVC-induced male infertility. In conclusion, the present findings emphasize the importance of understanding the molecular mechanisms behind UVC-induced male infertility and offer valuable insights into the protective mechanisms and prospective role of HES in safeguarding male reproductive health.

Anti-sperm Antibody Positivity in Men with Varicocele: A Systematic Review and Meta-Analysis

PURPOSE

Despite the significant role of varicocele in the pathogenesis of male infertility, its association with anti-sperm antibodies (ASA) remains controversial. This systematic review and meta-analysis (SRMA) aims to investigate the frequency of ASA positivity in men with varicocele.

MATERIALS AND METHODS

This SRMA is conducted in accordance with the Meta-analysis of Observational Studies in Epidemiology guidelines. We investigated the frequency of ASA positivity in ejaculates or serum of men with varicocele as compared to men without varicocele (controls). A literature search was performed using the Scopus and PubMed databases following the Population Exposure Comparison Outcome, Study Design model. Data extracted from eligible studies were meta-analyzed and expressed as odds ratios (ORs) and confidence intervals (CIs).

RESULTS

Out of 151 abstracts identified during the initial screening, 6 articles met the inclusion criteria and were included in the meta-analysis. Using mixed antiglobulin reaction (MAR) assay, 61 out of the 153 (39.8%) patients with varicocele tested positive for ASA in their ejaculates as compared to 22 out of the 129 control subjects (17%, OR=4.34 [95% CI: 1.09-17.28]; p=0.04). Using direct or indirect immunobead test, 30 out of 60 cases diagnosed with varicocele (50%) had shown ASA positivity in their ejaculates as compared to 16 out of 104 controls (15.4%, OR=3.57 [95% CI: 0.81-15.68]; p=0.09). Using enzyme-linked immunosorbent assay (ELISA), out of 89 varicocele patients, 33 (37.1%) tested positive for serum ASA as compared to 9 out of 57 participants in the control group (15.8%, OR=7.87 [95% CI: 2.39-25.89]; p<0.01).

CONCLUSIONS

This SRMA indicates that ASA positivity is significantly higher among men with varicocele when tested by direct method (MAR) or indirect method (ELISA). This data suggests an immunological pathology in infertile men with varicocele and may have implications for the management of these patients.

Sperm production, gonadal oxidative stress, DNA damage biomarkers and reproductive hormonal responses of cocks fed AFB1-contaminated diets supplemented with wireweed leaf

To assess the ameliorative effects of wireweed leaf supplement (WLS) and ascorbate on reproductive potentials and gonadal oxidative status of cocks fed aflatoxin B1 (AFB1) contaminated diets, a total of 250 sexually mature cocks were distributed into five treatment groups: 1 (Control/Basal diet), 2 (Basal + 1 mg/kg AFB1), 3 (Basal + 1 mg/kg AFB1 + 200 mg/kg Ascorbate), 4 (Basal + 1 mg/kg AFB1 + 2.50 g/kg WLS) and 5 (Basal + 1 mg/kg AFB1 + 5.00 g/kg WLS). Each group was replicated 5 times with 10 cocks per replicate. The cocks in group 2 recorded significantly (P < 0.05) reduced daily sperm production and efficiency; gonadal antioxidative enzymes: superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx), total proteins, luteinising hormone and testosterone concentrations while there were significant (P < 0.05) elevations in the gonadal malondialdehyde (MDA), myeloperoxidase (MPO) peroxidation activity, 8-hydroxy-2'-deoxyguanosine (8-OHdG) and nitric oxide (NO) levels when compared with cocks in the control group. However, cocks in groups 3, 4 and 5 recorded improvements in all the parameters studied when compared with group 2 cocks. Therefore, inclusions of WLS and ascorbate were beneficial to the reproductive potentials of cocks fed AFB1 contaminated diets.

Beta-Thalassemia and Male Infertility: Unraveling the Oxidative Stress Connection-An Up-to-Date Review

BACKGROUND/OBJECTIVES

Beta-thalassemia (BTH), a genetic disorder resulting from beta-globin gene mutations, affects over 1.5 million people globally. The disorder's multifactorial impact on male fertility, particularly through oxidative stress (OS), warrants focused study. This review examines the mechanisms of OS in TM, its implications for male infertility, and the potential of antioxidant therapies to mitigate fertility challenges.

METHODS

A non-systematic review was conducted using the PubMed, Cochrane, and Medscape databases, focusing on studies on beta-thalassemia (BTH), erectile dysfunction (ED), hormonal alterations, and OS. Studies were screened based on relevance, language, and topic, with 71 articles meeting the inclusion criteria after removing duplicates.

RESULTS

The findings reveal that OS, exacerbated by iron overload from regular blood transfusions, is significantly associated with impaired sperm quality and fertility in patients with TM. Iron toxicity affects gonadotropin levels, reduces sperm quality, and contributes to hypogonadism. Additionally, antioxidant therapies show promise in reducing OS-induced sperm damage, though efficacy is limited by a lack of robust clinical trials.

CONCLUSIONS

OS plays a considerable role in male infertility among patients with TM, primarily through iron-induced sperm damage and hormonal disruptions. While antioxidant therapies may offer a partial remedy, further research is necessary to understand OS's mechanisms in TM and develop effective fertility treatments. This review highlights the need for personalized antioxidant approaches to improve reproductive outcomes in this population.

Proteomics and Metabolomics in Varicocele-Associated Male Infertility: Advancing Precision Diagnostics and Therapy

Background/Objectives: Varicoceles are a common contributor to male infertility, significantly impacting male-factor infertility cases. Traditional diagnostic methods often lack the sensitivity to detect the molecular and cellular disruptions caused by varicoceles, limiting the development of effective, personalized treatments. This narrative review aims to explore the advancements in proteomics and metabolomics as innovative, non-invasive diagnostic tools for varicocele-associated male infertility and their potential in guiding personalized therapeutic strategies. Methods: A comprehensive literature search was conducted using databases such as PubMed, Scopus, and Web of Science up to October 2024. Studies focusing on the application of proteomic and metabolomic analyses in varicocele-associated male infertility were selected. The findings were critically analyzed to synthesize current knowledge and identify future research directions. Results: Proteomic analyses revealed differentially expressed proteins in the sperm and seminal plasma of varicocele patients, revealing disruptions in pathways related to oxidative stress, mitochondrial dysfunction, apoptosis, and energy metabolism. Key proteins such as heat shock proteins, mitochondrial enzymes, and apoptotic regulators were notably altered. Metabolomic profiling uncovered specific metabolites in seminal plasma-such as decreased levels of lysine, valine, and fructose-that correlate with impaired sperm function and fertility potential. The integration of proteomic and metabolomic data provides a comprehensive molecular fingerprint of varicocele-induced infertility, facilitating the identification of novel biomarkers for early diagnosis and the development of personalized therapeutic interventions. Conclusions: Advances in proteomics and metabolomics have significantly enhanced our understanding of the molecular mechanisms underlying varicocele-associated male infertility. These "omics" technologies hold great promise for improving diagnostic accuracy and personalizing treatment, ultimately leading to better outcomes for affected men. Future large-scale clinical trials and validations are essential to confirm these biomarkers and facilitate their integration into routine clinical practice.

Paternal Contributions to Recurrent Pregnancy Loss: Mechanisms, Biomarkers, and Therapeutic Approaches

Background and Objectives: Recurrent pregnancy loss (RPL) affects numerous couples worldwide and has traditionally been attributed mainly to maternal factors. However, recent evidence highlights significant paternal influences on pregnancy viability and outcomes. This review aims to comprehensively examine male contributions to pregnancy loss, focusing on underlying mechanisms, novel biomarkers, and integrated strategies for improved reproductive success. Materials and Methods: A comprehensive narrative review was conducted by searching databases including PubMed and Embase for the literature published from January 2004 to October 2024. Studies focusing on paternal influences in RPL-encompassing oxidative stress, genetic and epigenetic mechanisms, health conditions, lifestyle factors, environmental exposures, and advancements in sperm proteomics-were included. Inclusion criteria were peer-reviewed articles in English that directly addressed paternal factors in RPL; studies not meeting these criteria were excluded. Results: The review identified that paternal factors such as advanced age, metabolic and cardiovascular health issues, chronic diseases, lifestyle habits (e.g., smoking, alcohol consumption, poor diet), and environmental exposures significantly affect sperm integrity through mechanisms like oxidative stress, DNA fragmentation, and epigenetic alterations. Advanced paternal age and poor health conditions are associated with increased risks of miscarriage and adverse pregnancy outcomes. Novel sperm proteomic biomarkers have been identified, offering potential for enhanced diagnostics and personalized interventions. Integrated approaches involving multidisciplinary assessments, preventive strategies, and genetic counseling are essential for effectively addressing RPL. Conclusions: Integrating paternal factors into clinical evaluations is crucial for effectively addressing recurrent pregnancy loss. Recognizing and modifying paternal risk factors through lifestyle changes, medical interventions, and environmental management can improve pregnancy outcomes. The findings underscore the need for incorporating paternal assessments into standard care and highlight the importance of future research focusing on standardizing diagnostic protocols, expanding studies on paternal contributions, and integrating proteomic biomarkers into clinical practice to facilitate personalized treatment strategies.

Can Mammalian Reproductive Health Withstand Massive Exposure to Polystyrene Micro- and Nanoplastic Derivatives? A Systematic Review

The widespread use of plastics has increased environmental pollution by micro- and nanoplastics (MNPs), especially polystyrene micro- and nanoplastics (PS-MNPs). These particles are persistent, bioaccumulative, and linked to endocrine-disrupting toxicity, posing risks to reproductive health. This review examines the effects of PS-MNPs on mammalian reproductive systems, focusing on oxidative stress, inflammation, and hormonal imbalances. A comprehensive search in the Web of Science Core Collection, following PRISMA 2020 guidelines, identified studies on the impact of PS-MNPs on mammalian fertility, including oogenesis, spermatogenesis, and folliculogenesis. An analysis of 194 publications revealed significant reproductive harm, such as reduced ovarian size, depleted follicular reserves, increased apoptosis in somatic cells, and disrupted estrous cycles in females, along with impaired sperm quality and hormonal imbalances in males. These effects were linked to endocrine disruption, oxidative stress, and inflammation, leading to cellular and molecular damage. Further research is urgently needed to understand PS-MNPs toxicity mechanisms, develop interventions, and assess long-term reproductive health impacts across generations, highlighting the need to address these challenges given the growing environmental exposure.

Enhancing of Rabbit Sperm Cryopreservation with Antioxidants Mito-Tempo and Berberine

Cryopreservation plays a critical role in animal breeding and the conservation of endangered species, but it often compromises sperm characteristics such as morphology, motility, and viability due to oxidative stress. This study explores the antioxidative effect of Mito-Tempo (MT) and Berberine (BER) to enhance post-thaw sperm quality in rabbits. Pooled rabbit sperm samples were supplemented with different concentrations (0.0, 0.5, 5, 10, 50 µmol/L) of MT and BER. Sperm motility was evaluated using computer-assisted semen analysis, while viability, apoptosis, reactive oxygen species (ROS) levels, acrosome integrity, and mitochondrial function were assessed through flow cytometry. The results revealed that MT at 5 and 10 µmol/L and BER at 10 µmol/L significantly improved total and progressive motility, mitochondrial activity, and sperm viability compared to the control group. Furthermore, 10 µmol/L BER enhanced acrosome integrity, while both 5 µmol/L MT and 10 µmol/L BER effectively reduced ROS levels and apoptosis. This study is the first to demonstrate the protective effects of MT and BER on rabbit sperm during cryopreservation. By mitigating oxidative stress and reducing apoptosis, these antioxidants markedly improved post-thaw sperm quality, positioning MT and BER as promising agents for improving sperm cryosurvival.

Impact of Reductive Stress on Human Infertility: Underlying Mechanisms and Perspectives

Antioxidants have a well-established effect on general health and are essential in preventing oxidative damage to cells by scavenging free radicals. Free radicals are thought to be neutralized by these substances, which include polyphenols, β-carotene, and vitamins C and E, reducing cellular damage. On the other hand, recent data indicates that consuming excessive amounts of antioxidants may have side effects. Apoptosis and cell signaling are two beneficial physiological processes that are affected by excessive supplementation. Other negative effects include paradoxical enhancement of oxidative stress and unbalanced cellular redox potential. Overdosing on particular antioxidants has been associated with increased medication interactions, cancer progression, and fatality risks. Additionally, the complex impacts they may have on fertility might be both useful and adverse, depending on the quantity and duration of usage. This review delves into the dual role of antioxidants and emphasizes the importance of employing antioxidants in moderation. Antioxidant overconsumption may disrupt the oxidative balance necessary for normal sperm and oocyte function, which is one of the potential negative effects of antioxidants on fertility in both males and females that are also investigated. Although modest usage of antioxidants is generally safe and useful, high levels of antioxidants can upset hormonal balance, impair sperm motility, and negatively impact the outcomes of assisted reproductive technologies (ART). The findings emphasize the need to use antioxidant supplements in a balanced way, the importance of further research to optimize their use in fertility treatments, and the importance of supporting reproductive health to avoid adverse effects.

Assessing the efficacy of a novel sperm-washing medium enriched with serotonin, L-carnitine, and coenzyme Q10: an observational cohort study

ABSTRACT

This observational cohort study investigated the potential of a novel sperm-washing medium (SWM) enriched with serotonin (5-HT), L-carnitine (L-C), and coenzyme Q10 (CoQ10) to enhance sperm motility and reduce DNA damage. It compared this innovative medium (5-HT/L-C/CoQ10 SWM) with two widely used commercial media (SWM 1 and SWM 2). Ninety-eight volunteers from an infertility clinic provided semen samples, which were divided into three aliquots for analysis in different SWMs: group 1, SWM was composed of hydroxyethyl piperazineethanesulfonic acid (HEPES), sodium bicarbonate, human serum albumin (HSA), taurine, and gentamicin sulfate (SWM 1); group 2, SWM was composed of HEPES, sodium bicarbonate, and HSA (SWM 2); and group 3, SWM was composed of HEPES-buffered human tubal fluid supplemented with 5-HT, L-C, and CoQ10 (5-HT/L-C/CoQ10 SWM). Sperm motility was categorized as progressive, nonprogressive, or immotile. Apoptosis, reactive oxygen species (ROS) production, and DNA fragmentation were also assessed. There were no significant differences in total or progressive sperm motility among the groups. Spermatozoa in group 3 exhibited reduced apoptosis, necrosis, and ROS levels and increased viability. No significant differences were observed in the DNA fragmentation index among groups. The 5-HT/L-C/CoQ10 SWM reduced sperm oxidative stress and apoptosis compared with those of the two commercially available SWMs, suggesting that 5-HT/L-C/CoQ10 SWM could be useful for enhancing in vitro fertilization success rates.

The role of p53 in male infertility

The tumor suppressor p53 is a transcription factor involved in a variety of crucial cellular functions, including cell cycle arrest, DNA repair and apoptosis. Still, a growing number of studies indicate that p53 plays multiple roles in spermatogenesis, as well as in the occurrence and development of male infertility. The representative functions of p53 in spermatogenesis include the proliferation of spermatogonial stem cells (SSCs), spermatogonial differentiation, spontaneous apoptosis, and DNA damage repair. p53 is involved in various male infertility-related diseases. Innovative therapeutic strategies targeting p53 have emerged in recent years. This review focuses on the role of p53 in spermatogenesis and male infertility and analyses the possible underlying mechanism involved. All these conclusions may provide a new perspective on drug intervention targeting p53 for male infertility treatment.

Yoga: As a Transformative Approach to Addressing Male Infertility and Enhancing Reproductive Health in Men: A Narrative Review

Infertility presents multifaceted challenges that encompass both physical and emotional burdens. Yoga, as a comprehensive system of mind-body medicine, serves as an effective intervention for managing male factor infertility, a complex lifestyle disorder with significant psychosomatic elements. This review explores the transformative role of yoga in addressing both the emotional and physical dimensions of infertility. By incorporating physical postures, breath control and meditation, yoga promotes emotional well-being and enhances reproductive health by improving the integrity of nuclear and mitochondrial genomes as well as the epigenome. In addition, yoga contributes to maintaining sperm telomere length through the regulation of seminal free radical levels and increased telomerase activity, which are crucial for optimal embryo cleavage and the development of high-quality blastocysts. Integrating yoga as an adjunctive therapeutic approach fosters a supportive intrauterine environment and facilitates physiological homoeostasis, thereby increasing the likelihood of successful fertilisation and implantation. Gentle asanas and flowing sequences promote relaxation, alleviate tension and cultivate emotional stability, while meditation aids in emotional healing and resilience during the infertility journey. Specific asanas, such as Baddha Konasana (bound angle pose), Bhujangasana (cobra pose) and Sarvangasana (shoulder stand), stimulate reproductive organs, enhance blood circulation and regulate hormone production. Pranayama techniques further support endocrine balance and overall vitality. Moreover, yoga provides a non-invasive strategy for managing fertility-related conditions leading to improved reproductive health and overall well-being. This review aims to elucidate the comprehensive role of yoga in improving male infertility, focusing on its impact on sperm nuclear and mitochondrial genomes, the epigenome and telomere health. In addition, it underscores the importance of self-care, open communication and shared experiences with partners. Practicing yoga regularly supports psychosocial well-being, promotes holistic healing, enhances physical and mental health and probably helps in improving reproductive health, thereby fostering resilience and self-efficacy throughout the journey of fertility and reproduction.

L-carnitine combined with traditional Chinese medicine for male infertility: A systematic review and meta-analysis

Background

Fertility rates are declining globally, and male infertility is increasingly recognized as a significant challenge. This study aims to present the latest findings on the effectiveness and safety of combining traditional Chinese medicine (TCM) with L-carnitine (LC) for treating male infertility.

Methods

We searched 8 databases. Randomized controlled trials of TCM combined with LC therapy versus LC alone in the treatment of male infertility. The outcome included: pregnancy rate, sperm motility, concentration, volume, viability and liquefaction time. Subgroup analyses were also performed according to type of TCM, type of dosage form, and different TCM treatments, and the source of the high heterogeneity was explored. The study is registered on PROSPERO (CRD42023421497).

Results

1129 subjects from 12 of the 1833 eligible studies fulfilled the criteria. Compared with LC treatment alone, the combination of TCM and LC significantly improved pregnancy rate [RR = 1.65, 95 % CI (1.37-2.00)], grade (a+b) sperm motility [SMD = 1.56, 95 % CI (1.12, 2.01)], grade (a) sperm motility [SMD = 1.04, 95 % CI (0.69, 1.38)], sperm concentration [SMD = 1.39, 95 % CI (0.91, 1.86)], and sperm viability [SMD = 1.72, 95 % CI (0.83, 2.60)]. Subgroup analyses indicated that Compound Xuanju Capsule and Yougui Capsule demonstrated better efficacy. And the decoction and not-decoction each had their own advantages.

Conclusions

The combination of TCM with LC can have a dual effect: increasing pregnancy rates and sperm quality. Therefore, this combination is a recommended therapeutic strategy and a more appropriate type of TCM can be selected according to the patient's own characteristics.

Empirical Treatments for Male Infertility: A Focus on Lifestyle Modifications and Medicines

BACKGROUND/OBJECTIVES

Male infertility is a prevalent issue impacting numerous couples worldwide. This review aims to evaluate the effectiveness of empirical therapies for male infertility, focusing on both lifestyle modifications and medical treatments. This study provides a comprehensive overview of interventions aimed at improving male fertility outcomes.

METHODS

A thorough review of the existing literature was conducted, encompassing studies on lifestyle changes such as dietary changes, smoking cessation, alcohol moderation, and exercise. Additionally, medical treatments including selective estrogen receptor modulators, gonadotropins, aromatase inhibitors, phosphodiesterase-5 inhibitors, antioxidants, dopamine agonists, kallikrein, indomethacin, low-dose corticosteroids, alpha-blockers, and nitric oxide donors were evaluated. The study population included males diagnosed with infertility, focusing on various underlying causes.

RESULTS

Lifestyle modifications were found to have a positive impact on sperm quality. Evidence shows that a healthy diet, smoking cessation, moderate alcohol consumption, and regular exercise improve fertility outcomes. Medical treatments demonstrated significant improvements in sperm production and quality. Selective estrogen receptor modulators and gonadotropins enhanced sperm parameters. Aromatase inhibitors and phosphodiesterase-5 inhibitors specifically improved sperm motility and increased pregnancy rates. Antioxidants, such as vitamins E and C and coenzyme Q10, reduced oxidative stress and enhanced sperm counts, motility, and morphology. Dopamine agonists, particularly cabergoline, normalized prolactin levels and improved fertility outcomes. Kallikrein therapy improved sperm parameters and increased pregnancy rates. Indomethacin treatment was associated with increased sperm concentrations and motility. Low-dose corticosteroids and alpha-blockers showed variable results, and nitric oxide donors like L-arginine enhanced sperm counts and motility.

CONCLUSIONS

Empirical therapies, including lifestyle modifications and medical treatments, significantly enhance sperm quality and reproductive potential. These integrated approaches are essential in improving fertility outcomes in males. However, further extensive randomized trials are necessary to definitively establish the most effective treatments.

Coenzyme Q10 Improves the Post-Thaw Sperm Quality in Dwarf Surfclam Mulinia lateralis

Previous studies have shown that post-thaw sperm performance is affected by multiple stressors during cryopreservation, such as those induced by physical, chemical, mechanical and physiological changes. One of these is the balance disturbance between the antioxidant defense system and reactive oxygen species (ROS) production. This study investigated whether this disturbance could be alleviated by the addition of different antioxidants to cryoprotective solution [8% dimethyl sulfoxide (DMSO) in 1 µm filtered seawater] optimized for the sperm in dwarf surf clam Mulinia lateralis, the model bivalve species used in many different types of studies. Results showed that the addition of 20 μM coenzyme Q10 (Q10) to 8% DMSO achieved a D-stage larval rate similar to that of the fresh control at a sperm-to-egg ratio at least 50% less than the 8% DMSO treatment alone. The addition of other antioxidants (glycine, melatonin and polyvinylpyrrolidone) did not have any positive effects. The improvement in post-thaw sperm quality by Q10 could be due to its ability to significantly decrease ROS production and lipid peroxidation and significantly increase the motility, plasma membrane integrity, mitochondrial membrane potential, acrosome integrity, DNA integrity and activities of catalase and glutatione. In this study, 37 fatty acids (FAs) were quantified in dwarf surf clam sperm, with 21 FAs being significantly impacted by the cryopreservation with 8% DMSO. Thirteen of these 21 FAs were changed due to the addition of 20 μM Q10 to 8% DMSO, with approximately half of them being improved significantly toward the levels of fresh control, while the remaining half extended further from the trends shown with 8% DMSO treatment. However, no significant difference was found in the percentage of each FA category sum and the ratio of unsaturated/saturated FAs between the two treated groups. In conclusion, the antioxidant Q10 has shown the potential to further improve the sperm cryopreservation technique in bivalves.

External pressure induces the dysfunction of spermatogonia via triggering the intrinsic pathway of apoptosis

Background

Cryptorchidism, the failure of testes to descend into the scrotum, exposes the testes to higher temperature and external pressure. Scholars from Razi University found through research conducted at different pressure gradients (0, 25, 50, and 100 mmHg) and time gradients (2 and 4 h) that high hydrostatic pressure may lead to sperm apoptosis. In this work, we investigated the effect of external pressure on spermatogonia, exploring a new mechanism of male infertility caused by cryptorchidism.

Methods

Various pressure gradients (0, 25, 50, and 100 mmHg) were applied to spermatogonia for different durations (0, 2, and 4 h) in the Cell Counting Kit-8 (CCK8) experiment. Morphological changes, cell ultrastructure, apoptosis rates, and the expression of apoptosis-related proteins (bax, bcl-2, caspase-3, and caspase-9) were assessed through immunofluorescence, electron microscopy, terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) assay, flow cytometry, immunohistochemistry, real-time quantitative polymerase chain reaction (qPCR), and western blot.

Results

The cell viability assay showed that higher external pressure had a greater negative time-dependent impact on cell viability. Immunofluorescence results indicated that external pressure stimuli altered the morphology of spermatogonia. The results of TUNEL assay and flow cytometry demonstrated that external pressure stimuli induced apoptosis in spermatogonia. Transmission electron microscopy (TEM) observations showed the generation of apoptotic bodies, mitochondrial swelling, vacuolization, and mitochondrial cristae fusion. The results of immunohistochemistry indicated that pressure induced the expression of caspase-3 and caspase-9 proteins. qPCR and western blot analyses revealed an increased ratio of bax/bcl-2 and expression of caspase-3 and caspase-9. Methazolamide (cytochrome C inhibitor) blocked the pressure-induced cell apoptosis and inhibited the activation of caspase-3 while Z-IETD-FMK (caspase-8 inhibitor) did not.

Conclusions

External pressure promotes spermatogonia apoptosis through the intrinsic apoptosis pathway, which may be one of the mechanisms of male infertility induced by cryptorchidism.

Methylenetetrahydrofolate reductase (MTHFR) polymorphisms in andrology-a narrative review

Background and Objective

Methylenetetrahydrofolate reductase (MTHFR) is a key enzyme involved in folate metabolism and one-carbon metabolism. MTHFR gene polymorphism affects enzyme activity. MTHFR gene polymorphism is closely related to many human diseases, such as cardiocerebrovascular diseases, diabetes, neural tube defects (NTDs), tumors, and so on. In the field of Andrology, MTHFR gene polymorphism may be associated with male infertility and erectile dysfunction (ED), and there is a possibility of treating male infertility and ED by supplementing with folic acid. However, its exact pathophysiologic mechanism is not fully understood. We sought to obtain a robust understanding of the interactions between MTHFR gene polymorphism, oxidative stress, DNA methylation, hyperhomocysteinemia (HHcy), male infertility, and ED.

Methods

We performed a non-systematic literature review using the PubMed database to identify articles specifically related to MTHFR, male infertility and ED.

Key Content and Findings

Our literature review on MTHFR gene polymorphism in male infertility patients indicates a significant association between C677T gene polymorphism and male infertility. There is limited literature on the correlation between ED and MTHFR gene polymorphism, and there are two different conclusions, related and unrelated. More clinical data are needed to clarify the conclusion. There is a possibility of using folic acid supplementation to treat male infertility and ED, especially for patients with thymine-thymine (TT) genotype. Future research is necessary to further understand the relationship between MTHFR gene polymorphism and male infertility and ED.

Conclusions

Our literature review on MTHFR gene polymorphism in male infertility patients indicates a significant association between C677T gene polymorphism and male infertility. Folic acid supplementation can improve sperm quality. The correlation between MTHFR gene polymorphisms and ED is questionable and needs to be confirmed by more clinical data. MTHFR gene polymorphisms are associated with homocysteine (Hcy) levels, which affects vascular endothelial function and may be related to the development of vascular ED (VED). Folic acid supplementation improves International Index for Erectile Function (IIEF) questionnaire scores in ED patients in whom phosphodiesterase 5 inhibitor (PDE5i) alone is ineffective.

Oxidative Stress and Erectile Dysfunction: Pathophysiology, Impacts, and Potential Treatments

Erectile dysfunction (ED) is a prevalent condition affecting men's sexual health, with oxidative stress (OS) having recently been identified as a significant contributing causative factor. This narrative review aims to elucidate the role of OS in the pathophysiology of ED, focusing on impact, mechanisms, and potential therapeutic interventions. Key findings indicate that OS disrupts endothelial function and nitric oxide (NO) signaling, crucial for erectile function. Various sources of reactive oxygen species (ROS) and their detrimental effects on penile tissue are discussed, including aging, diabetes mellitus, hypertension, hyperlipidemia, smoking, obesity, alcohol consumption, psychological stress, hyperhomocysteinemia, chronic kidney disease, and sickle cell disease. Major sources of ROS, such as NADPH oxidase, xanthine oxidase, uncoupled endothelial NO synthase (eNOS), and mitochondrial electron transport, are identified. NO is scavenged by these ROS, leading to endothelial dysfunction characterized by reduced NO availability, impaired vasodilation, increased vascular tone, and inflammation. This ultimately results in ED due to decreased blood flow to penile tissue and the inability to achieve or maintain an erection. Furthermore, ROS impact the transmission of nitrergic neurotransmitters by causing the death of nitrergic neurons and reducing the signaling of neuronal NO synthase (nNOS), exacerbating ED. Therapeutic approaches targeting OS, including antioxidants and lifestyle modifications, show promise in ameliorating ED symptoms. The review underscores the need for further research to develop effective treatments, emphasizing the interplay between OS and vascular health in ED. Integrating pharmacological and non-pharmacological strategies could enhance clinical outcomes for ED patients, advocating for OS management in ED treatment protocols to improve patient quality of life.

Quality and kinematic characteristics of Bali bulls frozen semen with purified green tea extract epigallocatechin-3-gallate antioxidant addition in diluent

Background

The preservation of semen quality and kinematic characteristics during cryopreservation is crucial for the reproductive success and genetic management of livestock, particularly in Bali bulls.

Aim

This study aimed to investigate the effect of adding purified green tea extract antioxidant Epigallocatechin-3-gallate (EGCG) in tris egg yolk diluent on the quality and kinematic characteristics of frozen semen from Bali bulls.

Methods

Fresh and frozen semen samples were obtained from Bali bull and divided into four different treatment groups. P0 contained semen samples + diluent, while P1 to P3 consisted of semen samples + diluent supplemented with EGCG levels of 0.1, 0.15, and 0.2 mg/100 ml, respectively. Data were analyzed using One-way ANOVA and followed by Duncan's test if significant differences were found (p<0.05). Parameters observed included the assessment of fresh semen quality, kinematic analysis, post-thawing sperm viability, and abnormality.

Results

The results indicated that the assessment of fresh semen quality showed macroscopic and microscopic semen quality according to SNI 4869-1:2021. Kinematic analysis revealed significant differences in DSL and STR parameters between P0 and P3 (p<0.05). EGCG supplementation also caused significant differences in motility between P0 and P3 (p<0.05). Viability and spermatozoa abnormality with EGCG supplementation did not show significant differences (p>0.05).

Conclusion

The best results for motility, kinematics, and sperm morphology variables were found in P1 as it did not exhibit a decrease in motility, kinematics, and sperm morphology. Viability did not show significant differences between P1, P2, and P3, but the best results were found in P2 as it did not exhibit a decrease in viability with mean and standard deviation (66.84 ± 7.88). Abnormality variables also did not show significant differences between P1, P2, and P3, but the best results were found in P2 as it did not exhibit a decrease in abnormality with mean and standard deviation (23.80 ± 7.36).

Oxidative Stress-Associated Male Infertility: Current Diagnostic and Therapeutic Approaches

Infertility is a prevalent global issue affecting approximately 17.5% of adults, with sole male factor contributing to 20-30% of cases. Oxidative stress (OS) is a critical factor in male infertility, disrupting the balance between reactive oxygen species (ROS) and antioxidants. This imbalance detrimentally affects sperm function and viability, ultimately impairing fertility. OS also triggers molecular changes in sperm, including DNA damage, lipid peroxidation, and alterations in protein expression, further compromising sperm functionality and potential fertilization. Diagnostic tools discussed in this review offer insights into OS markers, antioxidant levels, and intracellular ROS concentrations. By accurately assessing these parameters, clinicians can diagnose male infertility more effectively and thus tailor treatment plans to individual patients. Additionally, this review explores various treatment options for males with OS-associated infertility, such as empirical drugs, antioxidants, nanoantioxidants, and lifestyle modifications. By addressing the root causes of male infertility and implementing targeted interventions, clinicians can optimize treatment outcomes and enhance the chances of conception for couples struggling with infertility.

Effects of Chicory (Cichorium intybus L.) Extract on Male Rat Reproductive System, Pregnancy and Offspring Development

BACKGROUND

We recently reported that extract prepared from the aerial part of Cichorium intybus L. (CE) possesses hepatoprotective, hypolipidemic, and hypoglycemic properties. This paper focuses on the effects of CE on the male rat reproductive system and the effects of this treatment on pregnancy and offspring development.

METHODS

The experimental male rats received 100 mg/kg bw/day, 500 mg/kg bw/day, and 1000 mg/kg bw/day of CE orally for 60 consecutive days. Rats that received tap water were used as controls. After treatment, we evaluated the effects of CE on the male reproductive system, fertility, and offspring development.

RESULTS

For CE-treated male rats, there was a significant increase in the (1) diameter of seminiferous tubules, (2) spermatogenic index, (3) number of total and motile spermatozoa, and (4) testosterone levels. Additionally, there was a decrease in the pre- and post-implantation death of the embryos in the CE-treated group. All pups born from CE-treated males demonstrated normal development.

CONCLUSIONS

CE treatment significantly improved male reproductive functions. No adverse effects on pregnancy and offspring development were observed when males were treated with CE. Further clinical evaluation of CE should lead to the development of a safe and effective phytodrug for treating male infertility.

Advanced Paternal Age in Focus: Unraveling Its Influence on Assisted Reproductive Technology Outcomes

As global demographics shift toward increasing paternal age, the realm of assisted reproductive technologies (ARTs), particularly in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), faces new challenges and opportunities. This study provides a comprehensive exploration of the implications of advanced paternal age on ART outcomes. Background research highlights the social, cultural, and economic factors driving men toward later fatherhood, with a focus on the impact of delayed paternity on reproductive outcomes. Methods involve a thorough review of existing literature, centering on changes in testicular function, semen quality, and genetic and epigenetic shifts associated with advancing age. Study results point to intricate associations between the father's age and ART outcomes, with older age being linked to diminished semen quality, potential genetic risks, and varied impacts on embryo quality, implantation rates, and birth outcomes. The conclusions drawn from the current study suggest that while advanced paternal age presents certain risks and challenges, understanding and mitigating these through strategies such as sperm cryopreservation, lifestyle modifications, and preimplantation genetic testing can optimize ART outcomes. Future research directions are identified to further comprehend the epigenetic mechanisms and long-term effects of the older father on offspring health. This study underscores the need for a comprehensive approach in navigating the intricacies of delayed fatherhood within the context of ART, aiming for the best possible outcomes for couples and their children.

Phytochemical Screening, Antioxidant Effect and Sperm Quality of the Bomba ceiba Stamen Extracts on Charolais Cattle Sperm Induced by Ferrous Sulfate

Orange Bombax ceiba (B. ceiba) is an indigenous plant, and its stamen is an important ingredient in traditional Lanna food. There are limitations in scientific reports on the effects of the biological activities of B. ceiba stamens on the male reproductive system. This study aims to investigate the phytochemical compounds of the orange B. ceiba stamen and its potential effect on the antioxidant properties and quality of cattle sperm treated with Fe. The orange BUE had the highest total phenolics, total tannins, total monomeric anthocyanins, and maximal antioxidant potential. The orange BAE had the highest concentration of total flavonoids. LC-QTOF/MS showed that the orange BUE contained the highest number of phytochemical compounds related to male reproductive enhancement. The orange BUE enhanced sperm motility, and both the orange BUE and the BAE enhanced sperm viability and normal sperm morphology via free radical scavenging. It might be suggested that B. ceiba stamens have benefits for sperm preservation, sperm quality, and increasing the economic value of local plants, and that they may be developed and used to guard against oxidative stress from cryodamage induced by frozen semen technology.