Causes, mechanisms, consequences and ways to correct sperm oxidative stress in the andrology laboratory

Male infertility, responsible for approximately 50% of infertility cases in couples, is a growing concern, with oxidative stress (OS) playing a key role in its etiology. OS in spermatozoa, characterized by an imbalance between reactive oxygen species (ROS) and antioxidants, leads to significant damage, including Deoxyribonucleic acid (DNA) fragmentation, reduced motility, and increased morphological defects. This review explores the causes, mechanisms, and consequences of sperm OS and identifies ways to address it within the andrology laboratory. Detecting and mitigating ROS levels is crucial for improving sperm quality, especially in assisted reproductive technology (ART) settings. It discusses endogenous and exogenous factors contributing to OS, such as systemic diseases, lifestyle choices, and cryopreservation processes. Notably, elevated ROS levels correlate with conditions like asthenozoospermia and teratozoospermia. Recent advancements in proteomics offer promising insights into the biomarkers of OS, which can aid in better diagnostic and therapeutic strategies. This review synthesizes current research on the causes, mechanisms, and consequences of sperm OS, highlighting diagnostic methods such as chemiluminescence assays and MiOXSYS (Male Infertility Oxidative System) for measuring ROS. Furthermore, methods for assessing OS, including flow cytometry, and redox potential systems, are examined. The review highlights the potential of antioxidant supplementation in mitigating sperm oxidative damage, particularly during cryopreservation. Various natural extracts, including those from sea cucumbers, cactus, and green tea, have shown promising effects in reducing ROS production and DNA fragmentation, thereby improving sperm quality. These findings underscore the importance of OS management in enhancing male fertility and improving ART outcomes.