{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:54:04Z","timestamp":1793120044712,"version":"4.5.0"},"reference-count":109,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CIMB"],"abstract":"<jats:p>Reproductive infertility is characterized by the inability to achieve pregnancy after a year or more of unprotected sexual intercourse. This review highlights the significant impact of exposure to both types of heavy metals (essential and non-essential) on the reproductive performance of various species, particularly humans. Heavy metals present a high atomic density and weight, including lead, mercury, cadmium, nickel, chromium, and arsenic, and are delivered into the environment through natural and human activities, posing a threat to ecological systems and human reproductive health. These heavy metals have the potential for bioaccumulation and can adversely affect male fertility and sperm quality due to their role in disrupting endocrine functions, altering hormone levels responsible for sperm production, and inducing oxidative stress. The elevated production of reactive oxygen species (ROS) exceeds the capability of antioxidants and can lead to the alteration of sperm quality. Seminal fluid contains antioxidants like vitamin C, vitamin E, zinc, and selenium to counteract the impacts of ROS and also to preserve the sperm function. This review aims also to explore the impact of heavy metals on sperm quality and their relationship with antioxidant imbalance and ROS. The exposure to heavy metals whether through occupational or environmental means increases the production of ROS and therefore leads to an imbalance of antioxidants production. All these factors have no doubt an impact on male reproductive health.<\/jats:p>","DOI":"10.3390\/cimb47080650","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T09:43:01Z","timestamp":1755078181000},"page":"650","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["A Narrative Review of Heavy Metals and Sperm Quality: The Interplay with Antioxidant Imbalance and Reactive Oxygen Species"],"prefix":"10.3390","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9303-8566","authenticated-orcid":false,"given":"Soukaina","family":"Azil","sequence":"first","affiliation":[{"name":"Immunopathology-Immunotherapy-Immunomonitoring Laboratory, Faculty of Medicine, Mohammed VI University of Sciences and Health, Casablanca 82403, Morocco"},{"name":"Environmental Health Laboratory, Institut Pasteur du Maroc, Casablanca 20360, Morocco"},{"name":"Laboratory of Medical Analysis and Reproductive Biology, Labomac, Casablanca 20250, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaoula","family":"Errafii","sequence":"additional","affiliation":[{"name":"African Genomic Center (AGC), University Mohamed VI Polytechnic, Bengurir 43150, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moncef","family":"Benkhalifa","sequence":"additional","affiliation":[{"name":"Reproductive Medicine, Reproductive Biology and Genetics, Peritox Laboratory, University Hospital and School of Medicine, Picardie University Jules Verne Amiens, 80054 Amiens, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noureddine","family":"Louanjli","sequence":"additional","affiliation":[{"name":"Laboratory of Medical Analysis and Reproductive Biology, Labomac, Casablanca 20250, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bouchra","family":"Ghazi","sequence":"additional","affiliation":[{"name":"Immunopathology-Immunotherapy-Immunomonitoring Laboratory, Faculty of Medicine, Mohammed VI University of Sciences and Health, Casablanca 82403, Morocco"},{"name":"IVF Laboratory, Department of Reproductive Medicine, Mohammed VI International University Hospital, Bouskoura 27182, Morocco"},{"name":"Mohammed VI Center for Research and Innovation (CM6RI), Rabat 10000, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salsabil","family":"Hamdi","sequence":"additional","affiliation":[{"name":"Environmental Health Laboratory, Institut Pasteur du Maroc, Casablanca 20360, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Dwyer, A.A., and Quinton, R. (2019). Anatomy and Physiology of the Hypothalamic-Pituitary-Gonadal (HPG) Axis. Advanced Practice in Endocrinology Nursing, Springer.","DOI":"10.1007\/978-3-319-99817-6_43"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1080\/10253890.2017.1369523","article-title":"Hypothalamic\u2013Pituitary\u2013Adrenal and Hypothalamic\u2013Pituitary\u2013Gonadal Axes: Sex Differences in Regulation of Stress Responsivity","volume":"20","author":"Oyola","year":"2017","journal-title":"Stress"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.ucl.2016.01.001","article-title":"Physiology of the Hypothalamic Pituitary Gonadal Axis in the Male","volume":"43","author":"Corradi","year":"2016","journal-title":"Urol. Clin."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.etap.2004.09.003","article-title":"Biological Markers for Metal Toxicity","volume":"19","author":"Kakkar","year":"2005","journal-title":"Environ. Toxicol. Pharmacol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1002\/jez.1738","article-title":"Effect of Restraint Stress on Lead-induced Male Reproductive Toxicity in Rats","volume":"317","author":"Reddy","year":"2012","journal-title":"J. Exp. Zool. A Ecol. Genet. Physiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1002\/mrd.23084","article-title":"Effective Attenuation of Glyphosate-induced Oxidative Stress and Granulosa Cell Apoptosis by Vitamins C and E in Caprines","volume":"86","author":"Bhardwaj","year":"2019","journal-title":"Mol. Reprod. Dev."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"77","DOI":"10.5534\/wjmh.2017.35.2.77","article-title":"Role of Antioxidants in Assisted Reproductive Techniques","volume":"35","author":"Agarwal","year":"2017","journal-title":"World J. Men\u2019s Health"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1089\/dna.2017.4081","article-title":"Toxic Effect of Cadmium, Lead, and Arsenic on the Sertoli Cell: Mechanisms of Damage Involved","volume":"37","year":"2018","journal-title":"DNA Cell Biol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Atig, F., Raffa, M., Habib, B.-A., Kerkeni, A., Saad, A., and Ajina, M. (2012). Impact of Seminal Trace Element and Glutathione Levels on Semen Quality of Tunisian Infertile Men. BMC Urol., 12.","DOI":"10.1186\/1471-2490-12-6"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Martinez, C.S., Torres, J.G.D., Pe\u00e7anha, F.M., Anselmo-Franci, J.A., Vassallo, D.V., Salaices, M., Alonso, M.J., and Wiggers, G.A. (2014). 60-Day Chronic Exposure to Low Concentrations of HgCl2 Impairs Sperm Quality: Hormonal Imbalance and Oxidative Stress as Potential Routes for Reproductive Dysfunction in Rats. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0111202"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"153787","DOI":"10.1016\/j.tox.2024.153787","article-title":"Reproductive Toxicity of Cadmium Stress in Male Animals","volume":"504","author":"Zhang","year":"2024","journal-title":"Toxicology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1017\/S0967199413000671","article-title":"Effect of in Vitro Exposure to Lead Chloride on Semen Quality and Sperm DNA Fragmentation","volume":"23","author":"Gomes","year":"2015","journal-title":"Zygote"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1002\/tox.22545","article-title":"Lead Exposure Reduces Sperm Quality and DNA Integrity in Mice","volume":"33","author":"Li","year":"2018","journal-title":"Environ. Toxicol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.fct.2013.08.052","article-title":"Daily Bioaccessible Levels of Selected Essential but Toxic Heavy Metals from the Consumption of Non-Dietary Food Sources","volume":"62","author":"Tongesayi","year":"2013","journal-title":"Food Chem. Toxicol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.taap.2010.08.003","article-title":"Head and Neck Cancer Due to Heavy Metal Exposure via Tobacco Smoking and Professional Exposure: A Review","volume":"248","author":"Khlifi","year":"2010","journal-title":"Toxicol. Appl. Pharmacol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.yrtph.2007.04.006","article-title":"Work in the Metal Industry and Nasopharyngeal Cancer Mortality among Formaldehyde-Exposed Workers","volume":"48","author":"Marsh","year":"2007","journal-title":"Regul. Toxicol. Pharmacol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1093\/aje\/kwh174","article-title":"Mortality from Solid Cancers among Workers in Formaldehyde Industries","volume":"159","author":"Hauptmann","year":"2004","journal-title":"Am. J. Epidemiol."},{"key":"ref_18","first-page":"S95","article-title":"\u00c9valuation de l\u2019exposition Professionnelle Au Plomb, Cadmium et Arsenic Dans Une Usine de Fabrication et Recyclage de Batteries Acides Au Plomb","volume":"35","author":"Bouchala","year":"2023","journal-title":"Toxicol. Anal. Et Clin."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.jhydrol.2014.11.034","article-title":"Modeling the Source Contribution of Heavy Metals in Surficial Sediment and Analysis of Their Historical Changes in the Vertical Sediments of a Drinking Water Reservoir","volume":"520","author":"Wang","year":"2015","journal-title":"J. Hydrol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"13","DOI":"10.5271\/sjweh.1060","article-title":"Influence of Pesticides on Male Fertility","volume":"33","author":"Bretveld","year":"2007","journal-title":"Scand. J. Work Environ. Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.envres.2015.01.004","article-title":"Associations between Urinary Organophosphate Pesticide Metabolite Levels and Reproductive Parameters in Men from an Infertility Clinic","volume":"137","author":"Melgarejo","year":"2015","journal-title":"Environ. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3109\/10408444.2010.515563","article-title":"Personal Care Products and Endocrine Disruption: A Critical Review of the Literature","volume":"40","author":"Witorsch","year":"2010","journal-title":"Crit. Rev. Toxicol."},{"key":"ref_23","first-page":"62","article-title":"Cadmium and Male Infertility","volume":"2","author":"Alaee","year":"2014","journal-title":"J. Infertil. Reprod. Biol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1016\/j.matdes.2014.10.025","article-title":"Effect of Heavy Metal Impurities in Secondary Mg Alloys on the Microstructure and Mechanical Properties during Deformation","volume":"65","year":"2015","journal-title":"Mater. Des."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"112135","DOI":"10.1016\/j.ecoenv.2021.112135","article-title":"Comparative Study on Protective Effect of Different Selenium Sources against Cadmium-Induced Nephrotoxicity via Regulating the Transcriptions of Selenoproteome","volume":"215","author":"Ge","year":"2021","journal-title":"Ecotoxicol. Environ. Saf."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3405089","DOI":"10.1155\/2017\/3405089","article-title":"Differential Susceptibility of Germ and Leydig Cells to Cadmium-Mediated Toxicity: Impact on Testis Structure, Adiponectin Levels, and Steroidogenesis","volume":"2017","author":"Cupertino","year":"2017","journal-title":"Oxidative Med. Cell. Longev."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1007\/s12011-019-01731-5","article-title":"Cadmium-Induced Testicular Toxicity in Mice: Subacute and Subchronic Route-Dependent Effects","volume":"193","author":"Mouro","year":"2020","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.tiv.2015.12.017","article-title":"Sub-Lethal Concentrations of CdCl2 Disrupt Cell Migration and Cytoskeletal Proteins in Cultured Mouse TM4 Sertoli Cells","volume":"32","author":"Egbowon","year":"2016","journal-title":"Toxicol. Vitr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"116","DOI":"10.4161\/spmg.1.2.16956","article-title":"Testosterone Signaling and the Regulation of Spermatogenesis","volume":"1","author":"Walker","year":"2011","journal-title":"Spermatogenesis"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/s12011-017-0998-y","article-title":"A Preliminary Study about the Potential Effects of Heavy Metals on the Human Male Reproductive Parameters in HIV-Infected Population in China","volume":"180","author":"Li","year":"2017","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1080\/09603123.2014.958137","article-title":"Role of Low Exposure to Metals as Male Reproductive Toxicants","volume":"25","author":"Jeng","year":"2015","journal-title":"Int. J. Environ. Health Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"767","DOI":"10.12891\/ceog3029.2015","article-title":"Environmental Pollution Due to Cadmium: Measure of Semen Quality as a Marker of Exposure and Correlation with Reproductive Potential","volume":"42","author":"Ianniello","year":"2015","journal-title":"Clin. Exp. Obstet. Gynecol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1007\/s10815-018-1236-z","article-title":"Associations of Semen Quality with Non-Essential Heavy Metals in Blood and Seminal Fluid: Data from the Environment and Male Infertility (EMI) Study in Lebanon","volume":"35","author":"Sukhn","year":"2018","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.repbio.2018.04.003","article-title":"Cadmium Effects on Sperm Morphology and Semenogelin with Relates to Increased ROS in Infertile Smokers: An in Vitro and in Silico Approach","volume":"18","author":"Ranganathan","year":"2018","journal-title":"Reprod. Biol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.envpol.2017.01.083","article-title":"Relationships between Seminal Plasma Metals\/Metalloids and Semen Quality, Sperm Apoptosis and DNA Integrity","volume":"224","author":"Wang","year":"2017","journal-title":"Environ. Pollut."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.enceco.2023.02.001","article-title":"Lead Pollution: Impact on Environment and Human Health and Approach for a Sustainable Solution","volume":"5","author":"Raj","year":"2023","journal-title":"Environ. Chem. Ecotoxicol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.toxlet.2019.10.012","article-title":"Lead-Mediated Inhibition of Lysine Acetylation and Succinylation Causes Reproductive Injury of the Mouse Testis during Development","volume":"318","author":"Yang","year":"2020","journal-title":"Toxicol. Lett."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1007\/s12011-018-1416-9","article-title":"Human Sperm Characteristics with Regard to Cobalt, Chromium, and Lead in Semen and Activity of Catalase in Seminal Plasma","volume":"188","author":"Wasilow","year":"2019","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e12750","DOI":"10.1111\/and.12750","article-title":"A Potential Mechanism Associated with Lead-induced Testicular Toxicity in Rats","volume":"49","author":"Kahilo","year":"2017","journal-title":"Andrologia"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1080\/09603123.2019.1625034","article-title":"Lead Acetate Induces Apoptosis in Leydig Cells by Activating PPAR\u03b3\/Caspase-3\/PARP Pathway","volume":"31","author":"Zhou","year":"2021","journal-title":"Int. J. Environ. Health Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/s12011-018-1358-2","article-title":"Carnosine and Histidine Supplementation Blunt Lead-Induced Reproductive Toxicity through Antioxidative and Mitochondria-Dependent Mechanisms","volume":"187","author":"Ommati","year":"2019","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_42","first-page":"137314","article-title":"Determination of Human Exposure to Mercury","volume":"312","author":"Melnik","year":"2023","journal-title":"Chemosphere"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Bank, M.S. (2012). Mercury in the Environment: Pattern and Process, University of California Press.","DOI":"10.1525\/california\/9780520271630.001.0001"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1007\/s12011-018-1424-9","article-title":"Levels of Essential and Xenobiotic Elements and Their Relationships in Milk Available on the Slovak Market with the Estimation of Consumer Exposure","volume":"188","author":"Capcarova","year":"2019","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.bj.2019.07.004","article-title":"Interventions of Aqueous Extract of Solanum Melongena Fruits (Garden Eggs) on Mercury Chloride Induced Testicular Toxicity in Adult Male Wistar Rats","volume":"43","author":"Adelakun","year":"2020","journal-title":"Biomed. J."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/1476-069X-10-6","article-title":"Relationships between Heavy Metal Concentrations in Three Different Body Fluids and Male Reproductive Parameters: A Pilot Study","volume":"10","author":"Mendiola","year":"2011","journal-title":"Environ. Health"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1080\/10934521003708992","article-title":"Concentration of Lead, Cadmium, Mercury and Arsenic in Leg Skeletal Muscles of Three Species of Wild Birds","volume":"45","author":"Gasparik","year":"2010","journal-title":"J. Environ. Sci. Health Part A"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1080\/10408440802233259","article-title":"The Endocrine Effects of Mercury in Humans and Wildlife","volume":"39","author":"Tan","year":"2009","journal-title":"Crit. Rev. Toxicol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1111\/bcpt.13264","article-title":"Mercury Exposure and Its Effects on Fertility and Pregnancy Outcome","volume":"125","author":"Chirumbolo","year":"2019","journal-title":"Basic Clin. Pharmacol. Toxicol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1111\/j.1471-0528.2002.02084.x","article-title":"Infertility, Blood Mercury Concentrations and Dietary Seafood Consumption: A Case\u2013Control Study","volume":"109","author":"Choy","year":"2002","journal-title":"BJOG"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Mukherjee, S., Gupte, T., Jenifer, S.K., Thomas, T., and Pradeep, T. (2019). Arsenic in Water: Speciation, Sources, Distribution, and Toxicology. Encyclopedia of Water: Science, Technology, and Society, John Wiley and Sons.","DOI":"10.1002\/9781119300762.wsts0053"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/S0039-9140(02)00268-0","article-title":"Arsenic Round the World: A Review","volume":"58","author":"Mandal","year":"2002","journal-title":"Talanta"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"77","DOI":"10.4103\/2305-0500.281077","article-title":"Effect of Aqueous Seed Extract of Mucuna Pruriens on Arsenic-Induced Testicular Toxicity in Mice","volume":"9","author":"Concessao","year":"2020","journal-title":"Asian Pac. J. Reprod."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"110360","DOI":"10.1016\/j.ecoenv.2020.110360","article-title":"Arsenite Induces Testicular Oxidative Stress in Vivo and in Vitro Leading to Ferroptosis","volume":"194","author":"Meng","year":"2020","journal-title":"Ecotoxicol. Environ. Saf."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1016\/j.chemosphere.2018.10.001","article-title":"Metal\/Metalloid Levels in Urine and Seminal Plasma in Relation to Computer-Aided Sperm Analysis Motion Parameters","volume":"214","author":"Wan","year":"2019","journal-title":"Chemosphere"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Uddin, M.H., and Rumman, M. (2020). Cobalt Toxicity and Human Health. Metal Toxicology Handbook, CRC Press.","DOI":"10.1201\/9780429438004-21"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1016\/j.envint.2007.10.006","article-title":"Cobalt and Secondary Poisoning in the Terrestrial Food Chain: Data Review and Research Gaps to Support Risk Assessment","volume":"34","author":"Hursthouse","year":"2008","journal-title":"Environ. Int."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1007\/s00776-013-0458-2","article-title":"Reproductive Toxicity in Adult Male Rats Following Intra-Articular Injection of Cobalt\u2013Chromium Nanoparticles","volume":"18","author":"Chen","year":"2013","journal-title":"J. Orthop. Sci."},{"key":"ref_59","first-page":"1","article-title":"Effects of Chronic Exposure to Cobalt Chloride on the Fertility and Testes in Mice","volume":"2","author":"Elbetieha","year":"2008","journal-title":"J. Appl. Biol. Sci."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e70175","DOI":"10.1111\/1541-4337.70175","article-title":"Aluminum in Beverages and Foods: A Comprehensive Compilation of Regulations; Concentrations in Raw, Prepared, and Stored Beverages and Foods; and Intake","volume":"24","author":"Yokel","year":"2025","journal-title":"Compr. Rev. Food Sci. Food Saf."},{"key":"ref_61","first-page":"5906","article-title":"Some Histological and Physiological Effects of Aluminum Chloride on Some Reproductive Organs of Male Albino Mice (Musmusculus)","volume":"25","author":"ALMurshidi","year":"2021","journal-title":"Ann. Rom. Soc. Cell Biol."},{"key":"ref_62","first-page":"215","article-title":"Human Sperm Quality and Metal Toxicants: Protective Effects of Some Flavonoids on Male Reproductive Function","volume":"10","author":"Jamalan","year":"2016","journal-title":"Int. J. Fertil. Steril."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1016\/j.fct.2009.02.006","article-title":"Propolis Protection from Reproductive Toxicity Caused by Aluminium Chloride in Male Rats","volume":"47","author":"Yousef","year":"2009","journal-title":"Food Chem. Toxicol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.tox.2005.06.025","article-title":"Aluminium-Induced Deterioration in Reproductive Performance and Seminal Plasma Biochemistry of Male Rabbits: Protective Role of Ascorbic Acid","volume":"215","author":"Yousef","year":"2005","journal-title":"Toxicology"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"120428","DOI":"10.1016\/j.envpol.2022.120428","article-title":"Exploring the Endocrine Disrupting Potential of Lead through Benchmark Modelling\u2013Study in Humans","volume":"316","author":"Javorac","year":"2023","journal-title":"Environ. Pollut."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"106115","DOI":"10.1016\/j.anireprosci.2019.106115","article-title":"Effect of Heavy Metals Arsenic, Cadmium, and Lead on the Semen Variables of Dromedary Camels (Camelus Dromedarius)","volume":"208","author":"Meligy","year":"2019","journal-title":"Anim. Reprod. Sci."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"214","DOI":"10.3390\/jox12030016","article-title":"Arsenic, Oxidative Stress and Reproductive System","volume":"12","author":"Zargari","year":"2022","journal-title":"J. Xenobiotics"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1080\/15569543.2024.2424791","article-title":"The Cytotoxic Implication of Cobalt on Male Reproductive Functions: A Review","volume":"44","author":"Ajayi","year":"2025","journal-title":"Toxin Rev."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"108524","DOI":"10.1016\/j.reprotox.2023.108524","article-title":"Cobalt\u2019s Role in Modulating Antioxidant Systems and Semen Quality in Males","volume":"123","author":"Tiszler","year":"2024","journal-title":"Reprod. Toxicol."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Darbandi, M., Darbandi, S., Agarwal, A., Sengupta, P., Durairajanayagam, D., Henkel, R., and Sadeghi, M.R. (2018). Reactive Oxygen Species and Male Reproductive Hormones. Reprod. Biol. Endocrinol., 16.","DOI":"10.1186\/s12958-018-0406-2"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1016\/j.rbmo.2014.02.004","article-title":"Sperm DNA Damage Caused by Oxidative Stress: Modifiable Clinical, Lifestyle and Nutritional Factors in Male Infertility","volume":"28","author":"Wright","year":"2014","journal-title":"Reprod. Biomed. Online"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1111\/andr.12210","article-title":"A Comprehensive Investigation of Sperm DNA Damage and Oxidative Stress Injury in Infertile Patients with Subclinical, Normozoospermic, and Astheno\/Oligozoospermic Clinical Varicocoele","volume":"4","author":"Ni","year":"2016","journal-title":"Andrology"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"668","DOI":"10.4103\/1008-682X.146967","article-title":"Effect of Transient Scrotal Hyperthermia on Sperm Parameters, Seminal Plasma Biochemical Markers, and Oxidative Stress in Men","volume":"17","author":"Rao","year":"2015","journal-title":"Asian J. Androl."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"e13617","DOI":"10.1111\/and.13617","article-title":"Obesity and Male Infertility: Mechanisms and Management","volume":"53","author":"Leisegang","year":"2021","journal-title":"Andrologia"},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Rato, L., Oliveira, P.F., Sousa, M., Silva, B.M., and Alves, M.G. (2019). Role of Reactive Oxygen Species in Diabetes-Induced Male Reproductive Dysfunction. Oxidants, Antioxidants and Impact of the Oxidative Status in Male Reproduction, Elsevier.","DOI":"10.1016\/B978-0-12-812501-4.00014-6"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1016\/S0015-0282(02)03294-6","article-title":"Effect of Cigarette Smoking on Levels of Seminal Oxidative Stress in Infertile Men: A Prospective Study","volume":"78","author":"Saleh","year":"2002","journal-title":"Fertil. Steril."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1093\/alcalc\/agh031","article-title":"Accuracy of Carbohydrate-Deficient Transferrin in the Detection of Excessive Alcohol Consumption: A Systematic Review","volume":"39","author":"Koch","year":"2004","journal-title":"Alcohol Alcohol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1007\/BF02912918","article-title":"Role of Reactive Oxygen Species and Antioxidants on Pathophysiology of Male Reproduction","volume":"21","author":"Maneesh","year":"2006","journal-title":"Indian J. Clin. Biochem."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1420","DOI":"10.1016\/j.fertnstert.2003.04.002","article-title":"Effects of Age on DNA Double-Strand Breaks and Apoptosis in Human Sperm","volume":"80","author":"Singh","year":"2003","journal-title":"Fertil. Steril."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"R189","DOI":"10.1530\/REP-19-0452","article-title":"Impact of Oxidative Stress on Male and Female Germ Cells: Implications for Fertility","volume":"159","author":"Aitken","year":"2020","journal-title":"Reproduction"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"145","DOI":"10.4103\/1947-489X.210375","article-title":"Significance of Some Trace Elements in Semen of Infertile Men","volume":"6","author":"Abed","year":"2014","journal-title":"Ibnosina J. Med. Biomed. Sci."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"124","DOI":"10.4103\/0974-1208.74153","article-title":"Relationship between Seminal Plasma Zinc and Semen Quality in a Subfertile Population","volume":"3","author":"Dissanayake","year":"2010","journal-title":"J. Hum. Reprod. Sci."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.nutres.2008.11.007","article-title":"Zinc Levels in Seminal Plasma Are Associated with Sperm Quality in Fertile and Infertile Men","volume":"29","author":"Colagar","year":"2009","journal-title":"Nutr. Res."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1016\/j.fertnstert.2005.05.020","article-title":"Molecular Aspects of Declining Sperm Motility in Older Men","volume":"84","author":"Henkel","year":"2005","journal-title":"Fertil. Steril."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.jtemb.2014.07.003","article-title":"The Role of Selenium in Human Conception and Pregnancy","volume":"29","author":"Grajeta","year":"2015","journal-title":"J. Trace Elem. Med. Biol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/s42000-019-00140-6","article-title":"Evidence for a Manifold Role of Selenium in Infertility","volume":"19","author":"Mintziori","year":"2020","journal-title":"Hormones"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1095\/biolreprod.102.003822","article-title":"Male Fertility Is Linked to the Selenoprotein Phospholipid Hydroperoxide Glutathione Peroxidase","volume":"67","author":"Foresta","year":"2002","journal-title":"Biol. Reprod."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1016\/j.bbrc.2013.12.067","article-title":"Selenoprotein P in Seminal Fluid Is a Novel Biomarker of Sperm Quality","volume":"443","author":"Michaelis","year":"2014","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.ajog.2011.07.034","article-title":"Selenium in Reproductive Health","volume":"206","author":"Mistry","year":"2012","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"3957","DOI":"10.1007\/s12011-021-03007-3","article-title":"The Association between Dietary Antioxidants and Semen Parameters: A Cross-Sectional Study among Iranian Infertile Men","volume":"200","author":"Talebi","year":"2022","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Mojadadi, A., Au, A., Salah, W., Witting, P., and Ahmad, G. (2021). Role for Selenium in Metabolic Homeostasis and Human Reproduction. Nutrients, 13.","DOI":"10.3390\/nu13093256"},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Cannarella, R., Condorelli, R.A., Calogero, A.E., Bagnara, V., Aversa, A., Greco, E.A., Brunetti, A., and La Vignera, S. (2021). Effects of Selenium Supplementation on Sperm Parameters and DNA-Fragmentation Rate in Patients with Chronic Autoimmune Thyroiditis. J. Clin. Med., 10.","DOI":"10.3390\/jcm10163755"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1111\/and.12521","article-title":"The Impact of Vitamin E Supplementation on Semen Parameters and Pregnancy Rates after Varicocelectomy: A Randomised Controlled Study","volume":"48","author":"Ener","year":"2016","journal-title":"Andrologia"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"9910","DOI":"10.3390\/ijms16059910","article-title":"Effects of Dietary Vitamin E on Fertility Functions in Poultry Species","volume":"16","author":"Rengaraj","year":"2015","journal-title":"Int. J. Mol. Sci."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1590\/S1677-5538.IBJU.2015.02.07","article-title":"The Effect of Adjuvant Vitamin C after Varicocele Surgery on Sperm Quality and Quantity in Infertile Men: A Double-Blind Placebo Controlled Clinical Trial","volume":"41","author":"Cyrus","year":"2015","journal-title":"Int. Braz. J. Urol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"138","DOI":"10.25122\/jml-2019-0107","article-title":"Protective Effect of Vitamin C and Zinc as an Antioxidant against Chemotherapy-Induced Male Reproductive Toxicity","volume":"13","author":"Hajjar","year":"2020","journal-title":"J. Med. Life"},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Banihani, S.A. (2017). Vitamin B12 and Semen Quality. Biomolecules, 7.","DOI":"10.3390\/biom7020042"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"e13877","DOI":"10.1111\/and.13877","article-title":"The Effect of Vitamin B12 Supplement on Post-thaw Motility, Viability and DNA Damage of Human Sperm","volume":"52","author":"Hosseinabadi","year":"2020","journal-title":"Andrologia"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1007\/s10815-013-0047-5","article-title":"Coenzyme Q10 and Male Infertility: A Meta-Analysis","volume":"30","author":"Lafuente","year":"2013","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"131","DOI":"10.52586\/S557","article-title":"Fortification Methods of Coenzyme Q10 in Yogurt and Its Health Functionality\u2014A Review","volume":"13","author":"Sarma","year":"2021","journal-title":"Front. Biosci. Sch."},{"key":"ref_101","doi-asserted-by":"crossref","unstructured":"Salvio, G., Cutini, M., Ciarloni, A., Giovannini, L., Perrone, M., and Balercia, G. (2021). Coenzyme Q10 and Male Infertility: A Systematic Review. Antioxidants, 10.","DOI":"10.3390\/antiox10060874"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"97","DOI":"10.5653\/cerm.2020.04175","article-title":"Coenzyme Q10, Oxidative Stress, and Male Infertility: A Review","volume":"48","author":"Alahmar","year":"2021","journal-title":"Clin. Exp. Reprod. Med."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1111\/and.12062","article-title":"Effect of Coenzyme Q10 Supplementation on Antioxidant Enzymes Activity and Oxidative Stress of Seminal Plasma: A Double-blind Randomised Clinical Trial","volume":"46","author":"Nadjarzadeh","year":"2014","journal-title":"Andrologia"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"150","DOI":"10.3109\/19396368.2015.1008071","article-title":"Oxidative Status in Testis and Epididymal Sperm Parameters after Acute and Chronic Stress by Cold-Water Immersion in the Adult Rat","volume":"61","year":"2015","journal-title":"Syst. Biol. Reprod. Med."},{"key":"ref_105","first-page":"BC01","article-title":"Effect of Ubiquinol Therapy on Sperm Parameters and Serum Testosterone Levels in Oligoasthenozoospermic Infertile Men","volume":"9","author":"Thakur","year":"2015","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1016\/j.fertnstert.2007.11.067","article-title":"L-Carnitine Decreases DNA Damage and Improves the in Vitro Blastocyst Development Rate in Mouse Embryos","volume":"91","author":"Abdelrazik","year":"2009","journal-title":"Fertil. Steril."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"e13267","DOI":"10.1111\/and.13267","article-title":"Double-blind, Randomised, Placebo-controlled Trial on the Effect of L-carnitine and L-acetylcarnitine on Sperm Parameters in Men with Idiopathic Oligoasthenozoospermia","volume":"51","author":"Micic","year":"2019","journal-title":"Andrologia"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1016\/j.fertnstert.2005.03.064","article-title":"Placebo-Controlled Double-Blind Randomized Trial on the Use of L-Carnitine, L-Acetylcarnitine, or Combined L-Carnitine and L-Acetylcarnitine in Men with Idiopathic Asthenozoospermia","volume":"84","author":"Balercia","year":"2005","journal-title":"Fertil. Steril."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1016\/j.fertnstert.2005.10.055","article-title":"Carnitine for the Treatment of Idiopathic Asthenospermia: A Randomized, Double-Blind, Placebo-Controlled Trial","volume":"85","author":"Sigman","year":"2006","journal-title":"Fertil. Steril."}],"container-title":["Current Issues in Molecular Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1467-3045\/47\/8\/650\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:26:12Z","timestamp":1760034372000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1467-3045\/47\/8\/650"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,13]]},"references-count":109,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["cimb47080650"],"URL":"https:\/\/doi.org\/10.3390\/cimb47080650","relation":{},"ISSN":["1467-3045"],"issn-type":[{"value":"1467-3045","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,13]]}}}