Ashok Agarwal , 1 , 2 , Neel Parekh 2 , Manesh Kumar Panner Selvam 1 , 2 , Ralf Henkel 1 , 3 , Rupin Shah 4 , Sheryl T. Homa 5 , Ranjith Ramasamy 6 , Edmund Ko 7 , Kelton Tremellen 8 , Sandro Esteves 9 , 10 , Ahmad Majzoub 1 , 11 , Juan G. Alvarez 12 , David K. Gardner 13 , Channa N. Jayasena 14 , 15 , Jonathan W. Ramsay 15 , Chak-Lam Cho 16 , Ramadan Saleh 17 , Denny Sakkas 18 , James M. Hotaling 19 , Scott D. Lundy 2 , Sarah Vij 2 , Joel Marmar 20 , Jaime Gosalvez 21 , Edmund Sabanegh 2 , Hyun Jun Park 22 , 23 , Armand Zini 24 , Parviz Kavoussi 25 , Sava Micic 26 , Ryan Smith 27 , Gian Maria Busetto 28 , Mustafa Emre Bakırcıoğlu 29 , Gerhard Haidl 30 , Giancarlo Balercia 31 , Nicolás Garrido Puchalt 32 , Moncef Ben-Khalifa 33 , Nicholas Tadros 34 , Jackson Kirkman-Browne 35 , 36 , Sergey Moskovtsev 37 , Xuefeng Huang 38 , Edson Borges Jr 39 , Daniel Franken 40 , Natan Bar-Chama 41 , Yoshiharu Morimoto 42 , Kazuhisa Tomita 42 , Vasan Satya Srini 43 , Willem Ombelet 44 , 45 , Elisabetta Baldi 46 , Monica Muratori 47 , Yasushi Yumura 48 , Sandro La Vignera 49 , Raghavender Kosgi 50 , Marlon P. Martinez 51 , Donald P. Evenson 52 , Daniel Suslik Zylbersztejn 53 , Matheus Roque 54 , Marcello Cocuzza 55 , Marcelo Vieira 56 , 57 , Assaf Ben-Meir 58 , Raoul Orvieto 59 , 60 , Eliahu Levitas 61 , Amir Wiser 62 , 63 , Mohamed Arafa 64 , Vineet Malhotra 65 , Sijo Joseph Parekattil 66 , 67 , Haitham Elbardisi 64 , Luiz Carvalho 68 , 69 , Rima Dada 70 , Christophe Sifer 71 , Pankaj Talwar 72 , Ahmet Gudeloglu 73 , Ahmed M.A. Mahmoud 74 , Khaled Terras 75 , Chadi Yazbeck 76 , Bojanic Nebojsa 77 , Damayanthi Durairajanayagam 78 , Ajina Mounir 79 , Linda G. Kahn 80 , Saradha Baskaran 1 , Rishma Dhillon Pai 81 , Donatella Paoli 82 , Kristian Leisegang 83 , Mohamed-Reza Moein 84 , Sonia Malik 85 , Onder Yaman 86 , Luna Samanta 87 , Fouad Bayane 88 , Sunil K. Jindal 89 , Muammer Kendirci 90 , Baris Altay 91 , Dragoljub Perovic 92 , Avi Harlev 93
08 May 2019
Despite advances in the field of male reproductive health, idiopathic male infertility, in which a man has altered semen characteristics without an identifiable cause and there is no female factor infertility, remains a challenging condition to diagnose and manage. Increasing evidence suggests that oxidative stress (OS) plays an independent role in the etiology of male infertility, with 30% to 80% of infertile men having elevated seminal reactive oxygen species levels. OS can negatively affect fertility via a number of pathways, including interference with capacitation and possible damage to sperm membrane and DNA, which may impair the sperm's potential to fertilize an egg and develop into a healthy embryo. Adequate evaluation of male reproductive potential should therefore include an assessment of sperm OS. We propose the term Male Oxidative Stress Infertility, or MOSI, as a novel descriptor for infertile men with abnormal semen characteristics and OS, including many patients who were previously classified as having idiopathic male infertility. Oxidation-reduction potential (ORP) can be a useful clinical biomarker for the classification of MOSI, as it takes into account the levels of both oxidants and reductants (antioxidants). Current treatment protocols for OS, including the use of antioxidants, are not evidence-based and have the potential for complications and increased healthcare-related expenditures. Utilizing an easy, reproducible, and cost-effective test to measure ORP may provide a more targeted, reliable approach for administering antioxidant therapy while minimizing the risk of antioxidant overdose. With the increasing awareness and understanding of MOSI as a distinct male infertility diagnosis, future research endeavors can facilitate the development of evidence-based treatments that target its underlying cause.