Idiopathic Infertility

Infertile men are diagnosed with idiopathic infertility when normal sperm parameters and no other clinical condition that may result in infertility are seen. Oxidative damage may be a contributing factor to infertility in these normozoospermic males. While the exact cause of infertility may be unknown, idiopathic infertility has been correlated with higher levels of ROS and lower antioxidant levels than in fertile men [58]. A study found that men with idiopathic infertility had the second highest level of OS among the clinical diagnoses studied [44]. Therefore, it would be expected that infertile men diagnosed with idiopathic infertility would benefit from antioxi-dant treatments. Idiopathic infertility has also been associated with increased sperm

DNA damage. A study by Wang et al. found a relationship between increased sperm damage by ROS and higher levels of cytochrome c and caspases 9 and 3 [3]. This may also indicate elevated apoptosis in males with idiopathic infertility.

Studies have reported that anywhere from 25 to 40% of males with idiopathic infertility have high ROS levels [59]. Idiopathic infertility may be explained by OS in infertile men with normal sperm and semen parameters [39]. Although idiopathic infertility may only be a temporary diagnosis, an estimated 64% of diagnosed males will remain infertile after 1 year [3]. The sperm mitochondria have also been found to be damaged by ROS production in men with idiopathic infertility. This mitochon-drial damage can lead to the release of proteins such as cytochrome c, and result in apoptosis and DNA damage [3] . However, apoptosis, DNA damage, and reduced sperm quality do not always present together [50].

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