Oxidative Stress and Male Infertility A Clinical Perspective

Kelton Tremellen

Abstract Studies have now conclusively linked impaired sperm function with reactive oxygen species attack on sperm—a process more commonly referred to as "oxidative stress". While research studies suggest that up to 80% of infertile men have evidence of oxidative stress, the majority of fertility specialists do not test their patients for oxidative stress, nor offer empirical antioxidant treatment. This is primarily due to a lack of availability of oxidative stress testing in the majority of clinical andrology laboratories, and a general ignorance of the importance of oxidative stress as a cause of male infertility amongst treating physicians. The first aim of this chapter is to outline the causes of oxidative stress so that they may be identified by simple history and examination. Sentinel signs of oxidative stress seen on routine semen analysis are then reviewed, together with a discussion of the benefits and pitfalls of direct testing for sperm oxidative stress. Finally, the management of sperm oxidative stress is outlined, including improvements in lifestyle, better management of underlying chronic illness, antioxidant medical therapy and surgical approaches to oxidative stress.

Keywords Oxidative stress • Clinical perspective • Identification of sperm oxidative stress • Routine semen analysis • Oral antioxidant therapy • Clinical examinations • Direct laboratory assessment

School of Pharmacy and Medical Science, University of South Australia,

Adelaide, SA, Australia

Repromed, 180 Fullarton Road, Dulwich, SA 5065, Australia e-mail: [email protected]

A. Agarwal et al. (eds.), Studies on Men's Health and Fertility, Oxidative Stress 325

in Applied Basic Research and Clinical Practice, DOI 10.1007/978-1-61779-776-7_16, © Springer Science+Business Media, LLC 2012

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