Conditions such as varicocele, genitourinary tract infection, leukocytospermia, and idiopathic infertility are associated with OS and have the potential of causing male factor infertility. Environmental factors such as smoking and pollution can also lead to elevated levels of ROS and subfertility in males. OS results in in vitro and in vivo clinical complications that may affect male fecundity. High ROS levels impair male fertility through lipid peroxidation, decreased motility, DNA damage, and apopto-sis. OS can be detected and treated to lower ROS levels. Various approaches are currently available to prevent and treat OS in vivo and in vitro, which may lead to improvement of male fertility. There is still a need for further investigation into the mechanisms and pathways that lead to oxidative damage, as well as the need for improved fertility treatments specific to OS and the related conditions.

• High levels of ROS or low levels of antioxidants can lead to OS, affecting male fertility.

• OS can impair male fertility through lipid peroxidation, decreased motility, DNA damage, and apoptosis.

• Clinical conditions associated with OS include varicocele, leukocytospermia, genitourinary tract infection, and idiopathic infertility.

• ROS levels can be diagnosed by the chemiluminescence assay, and OS can be identified using the TAC levels, and the ROS-TAC levels.

• Oral antioxidants and antioxidant treatment of the media culture may be helpful in ART procedures to prevent OS and improve fertility.

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