{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T04:39:58Z","timestamp":1785299998371,"version":"3.55.0"},"reference-count":89,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T00:00:00Z","timestamp":1632700800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antioxidants"],"abstract":"<jats:p>Male infertility, a relatively common and multifactorial medical condition, affects approximately 15% of couples globally. Based on WHO estimates, a staggering 190 million people struggle with this health condition, and male factor is the sole or contributing factor in roughly 20\u201350% of these cases. Nowadays, urologists are confronted with a wide spectrum of conditions ranging from the typical infertile male to more complex cases of either unexplained or idiopathic male infertility, requiring a specific patient-tailored diagnostic approach and management. Strikingly enough, no identifiable cause in routine workup can be found in 30% to 50% of infertile males. The medical term male oxidative stress infertility (MOSI) was recently coined to describe infertile men with abnormal sperm parameters and oxidative stress (OS), including those previously classified as having idiopathic infertility. OS is a critical component of male infertility, entailing an imbalance between reactive oxygen species (ROS) and antioxidants. ROS abundance has been implicated in sperm abnormalities, while the exact impact on fertilization and pregnancy has long been a subject of considerable debate. In an attempt to counteract the deleterious effects of OS, urologists resorted to antioxidant supplementation. Mounting evidence indicates that indiscriminate consumption of antioxidants has led in some cases to sperm cell damage through a reductive-stress-induced state. The \u201cantioxidant paradox\u201d, one of the biggest andrological challenges, remains a lurking danger that needs to be carefully avoided and thoroughly investigated. For that reason, oxidation-reduction potential (ORP) emerged as a viable ancillary tool to basic semen analysis, measuring the overall balance between oxidants and antioxidants (reductants). A novel biomarker, the Male infertility Oxidative System (MiOXSYS\u00ae), is a paradigm shift towards that goal, offering a quantification of OS via a quick, reliable, and reproducible measurement of the ORP. Moderation or \u201c\u039c\u03ad\u03c4\u03c1\u03bf\u03bd\u201d according to the ancient Greeks is the key to successfully safeguarding redox balance, with MiOXSYS\u00ae earnestly claiming its position as a guarantor of homeostasis in the intracellular redox milieu. In the present paper, we aim to offer a narrative summary of evidence relevant to redox regulation in male reproduction, analyze the impact of OS and reductive stress on sperm function, and shed light on the \u201cantioxidant paradox\u201d phenomenon. Finally, we examine the most up-to-date scientific literature regarding ORP and its measurement by the recently developed MiOXSYS\u00ae assay.<\/jats:p>","DOI":"10.3390\/antiox10101534","type":"journal-article","created":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T21:40:30Z","timestamp":1632778830000},"page":"1534","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Redox Balance in Male Infertility: Excellence through Moderation\u2014\u201c\u039c\u03ad\u03c4\u03c1\u03bf\u03bd \u1f04\u03c1\u03b9\u03c3\u03c4\u03bf\u03bd\u201d"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6360-0762","authenticated-orcid":false,"given":"Evangelos N.","family":"Symeonidis","sequence":"first","affiliation":[{"name":"Department of Urology, \u201cG. Gennimatas\u201d General Hospital, Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelini","family":"Evgeni","sequence":"additional","affiliation":[{"name":"Cryogonia Cryopreservation Bank, 11526 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasileios","family":"Palapelas","sequence":"additional","affiliation":[{"name":"3rd Department of Obstetrics and Gynecology, Hippokration General Hospital, School of Medicine, Aristotle University, 54642 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitra","family":"Koumasi","sequence":"additional","affiliation":[{"name":"Cryogonia Cryopreservation Bank, 11526 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7707-8426","authenticated-orcid":false,"given":"Nikolaos","family":"Pyrgidis","sequence":"additional","affiliation":[{"name":"Department of Urology, \u2018Martha-Maria\u2019 Hospital Nuremberg, 90491 Nuremberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1938-8004","authenticated-orcid":false,"given":"Ioannis","family":"Sokolakis","sequence":"additional","affiliation":[{"name":"Department of Urology, \u2018Martha-Maria\u2019 Hospital Nuremberg, 90491 Nuremberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3170-7362","authenticated-orcid":false,"given":"Georgios","family":"Hatzichristodoulou","sequence":"additional","affiliation":[{"name":"Department of Urology, \u2018Martha-Maria\u2019 Hospital Nuremberg, 90491 Nuremberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chara","family":"Tsiampali","sequence":"additional","affiliation":[{"name":"Independent Researcher, 54250 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Mykoniatis","sequence":"additional","affiliation":[{"name":"Department of Urology, \u201cG. Gennimatas\u201d General Hospital, Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5287-4450","authenticated-orcid":false,"given":"Athanasios","family":"Zachariou","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, Ioannina University, 45500 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Sofikitis","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, Ioannina University, 45500 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4651-312X","authenticated-orcid":false,"given":"Ares","family":"Kaltsas","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, Ioannina University, 45500 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fotios","family":"Dimitriadis","sequence":"additional","affiliation":[{"name":"Department of Urology, \u201cG. Gennimatas\u201d General Hospital, Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2665","DOI":"10.2174\/1381612826666200303115552","article-title":"Administration of Antioxidants in the Infertile Male: When it may have a Beneficial Effect?","volume":"27","author":"Kopa","year":"2021","journal-title":"Curr. Pharm. Des."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2757","DOI":"10.2174\/1381612826666200415173537","article-title":"Therapeutic effects of micronutrient supplements on sperm parameters: Fact or Fiction?","volume":"27","author":"Dimitriadis","year":"2021","journal-title":"Curr. Pharm. 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