Antioxidants in The Practice of Male Infertility; What Clinician Should Know Prior to Treatment by ART

Oxidative Stress (OS) is now widely recognized as a criticalmale infertility factor affecting semen parameters, sperm DNAintegrity, pregnancy and live-birth rates but most importantlythe health of the offspring. Since OS is a manifestation of aninsufficiency of cellular antioxidants, it stands to reason thatclinicians should consider antioxidant therapy to ameliorate itsdeleterious effects. The question now is no longer if cliniciansshould adopt antioxidant therapy as part of their best practice,but which combination of antioxidants offer OPTIMUM efficacyand safety for their patients. This is not an easy task forhealthcare practitioners to navigate, considering the worldwideavailability of some ۱۰۰ antioxidant formulations, each with different compositions and ingredient doses. On the other hand,without any recommendation from the treating physician, mendesperate to boost their fertility will choose antioxidant formulationsat random. Many such arbitrary formulations, withoutpublished design rationale or credible clinical evidence, carrythe serious risk of over-supplementation, which in fact mayreduce fertility potential rather than improve it. Therefore, theneed for convincing evidence from large quality clinical trialswith antioxidants is now greater than ever. In the meantime,clinicians should still consider antioxidant therapy but pay meticulousattention to the evidence published for their design,safety and efficacy. In this short overview, we highlight the importanceof antioxidant therapy together with guidelines aimedto provide greater awareness for clinicians to navigate this complexfield.