Oxidative stress

Oxidative stress is caused by an increase in ROS (reactive oxygen species), which in turn may cause damage to our body’s cells and DNA and thus it may also affect semen quality. Increased oxidative stress has been shown to affect sperm morphology and motility, fertilization of the oocyte and ultimately DNA integrity.

Despite the effectiveness of semen analysis, it is not always enough to fully assess male infertility, as some men still have difficulties even though their semen analysis results are normal. In such cases in particular, oxidative stress assessment may offer a more complete picture of the underlying etiologic factor and guide clinical management.

Oxidative stress assessment analyses the balance of oxidants and anti-oxidants in the sperm. Additionally, it can assess the antioxidant capabilities of the sperm’s own correction mechanisms and diagnose deficiencies. Oxidative stress assessment may be performed alongside conventional semen analysis from the same sperm sample.

With regard to clinical application, oxidative stress assessment may be useful in the following cases:

  • Unexplained infertility
  • Indications of increased sperm oxidation:
    • Poor sperm motility (asthenospermia)
    • Poor sperm morphology (teratospermia)
    • Increased white blood cells in the sample – infection
    • Increased DNA Fragmentation Index (DFI)
  • Endogenous causes of increased oxidation:
    • Varicocele
    • Hormonal abnormalities
    • Aging
    • Diabetes
    • Chronic psychological stress
  • Exogenous causes of increased oxidation
    • Smoking
    • Alcohol consumption
    • Substance abuse
    • Certain medication (chemotherapy etc)
    • Environmental exposure (radiation, industrial chemicals etc)
    • Poor diet and obesity

Overall, the available treatment strategy is to reduce oxidization and to increase sperm anti-oxidants. Therefore, treatment includes:

Reduce the effect of risk factors

  • Healthier lifestyle
  • Weight reduction
  • Smoking cessation
  • Alcohol reduction
  • Varicocele repair, when indicated

Antioxidant administration

  • Vitamin C
  • Vitamin E
  • Selenium
  • Zinc
  • Folic acid