Clinical Treatment

Various forms of drug therapies against the presence of ROS have been developed as a result of research showing the harmful effect of these biomolecules, the first approach being drugs which can inhibit the formation of ROS [1]. The second is the stimulation of endogenous defense mechanisms because ROS are part of the initial protection against inflammation [1, 11]. The use of antioxidants is regarded as the most logical approach in the clinical intervention to treat the free radical's harmful effects [31] . It has been put forward that semen from males presenting with high concentrations of leukocytes and therefore OS may benefit from supplementary treatment with selected oral antioxidants [10, 15]. even if subjects have normal semen analysis [54]. The intake may improve the functional properties of spermatozoa such as sperm's capability of successful oocyte fusion by providing protection from peroxidative damage [31, 83] . At present, the Cochrane Review provides evidence which suggests that subfertile couples involved in ART have increased chances of pregnancy and live birth rates, if the male subject receives an oral supplementation of antioxidants [84],

The supplementation with antioxidants during the preparation processes performed for ART such as density gradient centrifugation has been proposed and evaluated in the treatment pathway for ROS generation [31]. In addition, sperm-oocyte fusion can be enhanced by halting the production of ROS by immature spermatozoa and leukocytes by the addition of antioxidants to the culture media [85] .

In addition to antioxidants, the pharmacological treatment of leukocytospermia with therapeutic concentrations of specific antibiotics has been shown to decrease leukocyte-produced ROS. Example of such drugs includes tetracycline and erythromycin, which can inhibit the actions of PMN-granulocyte I 1]. Pharmacological findings further open the avenue for the treatment of leukocytospermia with drugs to avoid a state of damaging OS. Diagnostic and prognostic tests which allow for the measurement of the OS levels could be a considerable contributing factor in the treatment of idiopathic infertility [38]. Dietary supplementation with foods containing high concentrations of antioxidants such as carotenoids, vitamin C, and the main chain-breaking antioxidant vitamin E offers an additional line of defense against OS-induced injury [82]. An additional avenue into the beneficial effect that antioxidants have is shown by the cyroprotective effect that they have over sperm when added as supplements in the cyropreservation process [86] .

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