Optimizing male fertility: oxidative stress and the use of antioxidants

Management of male infertility is always a difficult task, with pathophysiology and available treatments often poorly understood. The purpose of this review was to summarize current evidence regarding the use of protective agents against reactive oxygen species (ROS), such as antioxidants that may be useful in the treatment of male factor infertility.

For this publication, a search of studies concerning oxidative stress, male infertility and antioxidant therapy was performed using the search engines ScienceDirect, OVID, PubMed and MEDLINE. Articles published in languages other than English were not considered.

An interest in the physiologic and pathologic effects of ROS has grown. Nevertheless, use of antioxidants is challenging, considering the balance between physiological ROS activity and detrimental oxidative stress level. Several studies have shown positive outcomes in terms of semen parameters, with others having failed to do so. Available evidence is still limited in pregnancy and live birth rates.

Protective agents against ROS, such as antioxidants, may have positive effects on semen parameters in some patients, although a widespread indication is still restricted by practical aspects, including unknown physiological levels of ROS and controversy regarding different concentrations and combinations of drugs.