Oxidative stress (OS), a state characterized by an imbalance between pro-oxidant molecules including reactive oxygen and nitrogen species, and antioxidant defenses, has been identified to play a key role in the pathogenesis of subfertility in both males and females. The adverse effects of OS on sperm quality and functions have been well documented. In females, on the other hand, the impact of OS on oocytes and reproductive functions remains unclear. This imbalance between pro-oxidants and antioxidants can lead to a number of reproductive diseases such as endometriosis, polycystic ovary syndrome (PCOS), and unexplained infertility. Pregnancy complications such as spontaneous abortion, recurrent pregnancy loss, and preeclampsia, can also develop in response to OS. Studies have shown that extremes of body weight and lifestyle factors such as cigarette smoking, alcohol use, and recreational drug use can promote excess free radical production, which could affect fertility. Exposures to environmental pollutants are of increasing concern, as they too have been found to trigger oxidative states, possibly contributing to female infertility. This article will review the currently available literature on the roles of reactive species and OS in both normal and abnormal reproductive physiological processes. Antioxidant supplementation may be effective in controlling the production of ROS and continues to be explored as a potential strategy to overcome reproductive disorders associated with infertility. However, investigations conducted to date have been through animal or in vitro studies, which have produced largely conflicting results. The impact of OS on assisted reproductive techniques (ART) will be addressed, in addition to the possible benefits of antioxidant supplementation of ART culture media to increase the likelihood for ART success. Future randomized controlled clinical trials on humans are necessary to elucidate the precise mechanisms through which OS affects female reproductive abilities, and will facilitate further explorations of the possible benefits of antioxidants to treat infertility.

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The effects of oxidative stress on female reproduction: a review

Infertility affects approximately 15% of couples trying to conceive, and a male factor contributes to roughly half of these cases. Oxidative stress (OS) has been identified as one of the many mediators of male infertility by causing sperm dysfunction. OS is a state related to increased cellular damage triggered by oxygen and oxygen-derived free radicals known as reactive oxygen species (ROS). During this process, augmented production of ROS overwhelms the body's antioxidant defenses. While small amounts of ROS are required for normal sperm functioning, disproportionate levels can negatively impact the quality of spermatozoa and impair their overall fertilizing capacity. OS has been identified as an area of great attention because ROS and their metabolites can attack DNA, lipids, and proteins; alter enzymatic systems; produce irreparable alterations; cause cell death; and ultimately, lead to a decline in the semen parameters associated with male infertility. This review highlights the mechanisms of ROS production, the physiological and pathophysiological roles of ROS in relation to the male reproductive system, and recent advances in diagnostic methods; it also explores the benefits of using antioxidants in a clinical setting.

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Effect of oxidative stress on male reproduction.

https://faculty.missouri.edu/~glaserr/3700s14/Antioxidant_Vitamins_C_and_E.pdf

Vitamins C and E: beneficial effects from a mechanistic perspective.

Approximately 10 to 15% of couples are impacted by infertility. Recently, the pivotal role that lifestyle factors play in the development of infertility has generated a considerable amount of interest. Lifestyle factors are the modifiable habits and ways of life that can greatly influence overall health and well-being, including fertility. Many lifestyle factors such as the age at which to start a family, nutrition, weight, exercise, psychological stress, environmental and occupational exposures, and others can have substantial effects on fertility; lifestyle factors such as cigarette smoking, illicit drug use, and alcohol and caffeine consumption can negatively influence fertility while others such as preventative care may be beneficial. The present literature review encompasses multiple lifestyle factors and places infertility in context for the couple by focusing on both males and females; it aims to identify the roles that lifestyle factors play in determining reproductive status. The growing interest and amount of research in this field have made it evident that lifestyle factors have a significant impact on fertility.

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Lifestyle factors and reproductive health: taking control of your fertility

Background: In recent times there has been some controversy over the impact of electromagnetic radiation on human health. The significance of mobile phone radiation on male reproduction is a key element of this debate since several studies have suggested a relationship between mobile phone use and semen quality. The potential mechanisms involved have not been established, however, human spermatozoa are known to be particularly vulnerable to oxidative stress by virtue of the abundant availability of substrates for free radical attack and the lack of cytoplasmic space to accommodate antioxidant enzymes. Moreover, the induction of oxidative stress in these cells not only perturbs their capacity for fertilization but also contributes to sperm DNA damage. The latter has, in turn, been linked with poor fertility, an increased incidence of miscarriage and morbidity in the offspring, including childhood cancer. In light of these associations, we have analyzed the influence of RF-EMR on the cell biology of human spermatozoa in vitro. Principal Findings: Purified human spermatozoa were exposed to radio-frequency electromagnetic radiation (RF-EMR) tuned to 1.8 GHz and covering a range of specific absorption rates (SAR) from 0.4 W/kg to 27.5 W/kg. In step with increasing SAR, motility and vitality were significantly reduced after RF-EMR exposure, while the mitochondrial generation of reactive oxygen species and DNA fragmentation were significantly elevated (P,0.001). Furthermore, we also observed highly significant relationships between SAR, the oxidative DNA damage bio-marker, 8-OH-dG, and DNA fragmentation after RF-EMR exposure. Conclusions: RF-EMR in both the power density and frequency range of mobile phones enhances mitochondrial reactive oxygen species generation by human spermatozoa, decreasing the motility and vitality of these cells while stimulating DNA base adduct formation and, ultimately DNA fragmentation. These findings have clear implications for the safety of extensive mobile phone use by males of reproductive age, potentially affecting both their fertility and the health and wellbeing of their offspring.

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Mobile phone radiation induces reactive oxygen species production and dna damage in human spermatozoa in vitro

http://www.next-up.org/pdf/OfficialJournalAmericanSocietyReproductiveMedecineEffectCcellPhoneSemenAnalysisObservationalStudy012008.pdf

Effect of cell phone usage on semen analysis in men attending infertility clinic: an observational study

Background Preeclampsia is characterized by increased lipid peroxidation and diminished antioxidant capacity; however, there is no consensus as to the extent of these conditions. Objective To assess the association of lipid peroxidation and antioxidant status with preeclampsia quantitatively using meta-analysis. Design Systematic review and meta-analysis. Search strategy Studies were identified by performing an extensive search using BIOSIS (1986-2007), EMBASE (1986-2007), Medline (1986-2007), and the Cochrane database. Data analysis Standardized mean differences (SMD) with 95% confidence intervals (CI) were used in the meta-analysis and sources of heterogeneity were examined. Main results In the included studies, the overall SMD was a 1.21 nmol/mL increase in serum malondialdehyde in preeclampsia cases compared to controls (95% CI: 0.76, 1.66). Overall, total serum thiobarbituric acid-reactive substances SMD were 1.62 nmol/mL greater in cases than in controls (95% CI: 0.27, 2.96). The overall estimate SMD for serum vitamin E was 1.12 nmol/mL less in cases than controls (95% CI: -1.77, -0.48) and vitamin C SMD overall estimate was -0.53 (95%CI: -1.03, -0.02), significantly lower in cases compared with controls. The overall SMD for erythrocyte superoxide dismutase was -2.37 (95% CI: -4.76, 0.03), a marginally significant decrease in cases versus controls. Conclusions Established preeclampsia is associated with increased concentrations of oxidative stress markers including lipid peroxidation products, and a reduction in antioxidant concentrations. Target audience Obstetricians & Gynecologists, Family Physicians. Learning objectives After completion of this educational activity, the participant should be better able to describe the pattern of oxidative stress markers associated with preeclampsia, and interpret the available literature as it relates to oxidative stress and preeclampsia.

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Lipid peroxidation and antioxidant status in preeclampsia: a systematic review.

https://www.clevelandclinic.org/reproductiveresearchcenter/docs/agradoc244.pdf

Relationship of adolescent gynecomastia with varicocele and somatometric parameters: a cross-sectional study in 6200 healthy boys.

https://www.fertstert.org/article/S0015-0282(14)02225-0/pdf

Analysis of semen parameters in male referrals: impact of reference limits, stratification by fertility categories, predictors of change, and comparison of normal semen parameters in subfertile couples.

Jianbo Li

Papers

Effect of cell phone usage on semen analysis in men attending infertility clinic: an observational study

Lipid peroxidation and antioxidant status in preeclampsia: a systematic review.

Relationship of adolescent gynecomastia with varicocele and somatometric parameters: a cross-sectional study in 6200 healthy boys.

Analysis of semen parameters in male referrals: impact of reference limits, stratification by fertility categories, predictors of change, and comparison of normal semen parameters in subfertile couples.

Pd20-12 development of a clinically relevant symptom index to assess patients with chronic orchialgia