{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T14:08:05Z","timestamp":1792591685784,"version":"4.5.0"},"reference-count":135,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Conventional semen analysis frequently fails to identify the underlying pathophysiology of male infertility, which is a complicated clinical disease, especially in cases of idiopathic infertility. A growing body of research indicates that inflammation and oxidative stress (OS) are important and related factors in male reproductive failure. Excessive reactive oxygen species (ROS) promote lipid peroxidation, protein oxidation, mitochondrial dysfunction, and sperm DNA fragmentation, thereby compromising motility, morphology, and fertilizing capacity. Concurrently, pro-inflammatory mediators like interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-alpha (TNF-\u03b1) are frequently found in the seminal plasma of infertile men and are linked to poor semen parameters and testicular dysfunction. It is crucial that oxidative and inflammatory pathways work together to create a self-sustaining pathophysiological cycle that exacerbates sperm damage and destabilizes the reproductive milieu. The diagnostic significance, clinical suitability, and limitations of oxidative stress and inflammation biomarkers, such as malondialdehyde (MDA), 8-hydroxy-2\u2032-deoxyguanosine (8-OHdG), total antioxidant capacity (TAC), and specific inflammatory markers, are critically assessed in this comprehensive review. The lack of established diagnostic thresholds, methodological variation, and translational issues that still restrict their widespread clinical implementation are highlighted in particular. Additionally, the potential contribution of biomarker-guided approaches to focused therapy decisions and individualized patient management is explored. This study examines how oxidative and inflammatory markers may complement conventional male infertility assessments by supporting more precise, mechanism-based approaches in reproductive medicine, while addressing diagnostic readiness and translational limitations.<\/jats:p>","DOI":"10.3390\/diagnostics16040527","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T12:07:06Z","timestamp":1770725226000},"page":"527","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Oxidative Stress and Inflammatory Biomarkers in Male Infertility: A Narrative Review of Diagnostic Value and Clinical Integration"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9553-6803","authenticated-orcid":false,"given":"Athanasios","family":"Zikopoulos","sequence":"first","affiliation":[{"name":"Torbay and South Devon NHS Foundation Trust Lowes Brg, Torquay TQ2 7AA, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4112-8396","authenticated-orcid":false,"given":"Panagiotis","family":"Christopoulos","sequence":"additional","affiliation":[{"name":"Second Department of Obstetrics and Gynecology, \u201cAretaieion\u201d Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodoros","family":"Kalampokas","sequence":"additional","affiliation":[{"name":"Second Department of Obstetrics and Gynecology, \u201cAretaieion\u201d Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9296-3688","authenticated-orcid":false,"given":"Angeliki","family":"Gerede","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Democritus University of Thrace, Alexandroupolis Campus, 69100 Alexandroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3333-2620","authenticated-orcid":false,"given":"Efthalia","family":"Moustakli","sequence":"additional","affiliation":[{"name":"Department of Nursing, School of Health Sciences, University of Ioannina, 45500 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1254-1984","authenticated-orcid":false,"given":"Ioannis","family":"Arkoulis","sequence":"additional","affiliation":[{"name":"First Department of Obstetrics and Gynecology, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spyridon","family":"Topis","sequence":"additional","affiliation":[{"name":"First Department of Obstetrics and Gynecology, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7716-1521","authenticated-orcid":false,"given":"Anastasios","family":"Potiris","sequence":"additional","affiliation":[{"name":"First Department of Obstetrics and Gynecology, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2990-640X","authenticated-orcid":false,"given":"Chrysi","family":"Christodoulaki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, General Hospital of Chania, 73300 Chania, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4337-7871","authenticated-orcid":false,"given":"Ioannis","family":"Tsakiridis","sequence":"additional","affiliation":[{"name":"Third Department of Obstetrics and Gynecology, General Hospital Ippokratio, Medical School, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2863-5839","authenticated-orcid":false,"given":"Themistoklis","family":"Dagklis","sequence":"additional","affiliation":[{"name":"Third Department of Obstetrics and Gynecology, General Hospital Ippokratio, Medical School, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofoklis","family":"Stavros","sequence":"additional","affiliation":[{"name":"First Department of Obstetrics and Gynecology, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1016\/j.fertnstert.2018.08.015","article-title":"Male infertility as a window to health","volume":"110","author":"Choy","year":"2018","journal-title":"Fertil. Steril."},{"key":"ref_2","unstructured":"Leslie, S.W., Soon-Sutton, T.L., and Khan, M.A. (2024, August 12). Male Infertility, StatPearls [Internet], Available online: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK562258\/."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1080\/20905998.2024.2381972","article-title":"Idiopathic male infertility\u2014What are we missing?","volume":"23","author":"Boeri","year":"2025","journal-title":"Arab. J. Urol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Dutta, S., Sengupta, P., Slama, P., and Roychoudhury, S. (2021). Oxidative Stress, Testicular Inflammatory Pathways, and Male Reproduction. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms221810043"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e12598","DOI":"10.1002\/rmb2.12598","article-title":"Oxidative stress affects sperm health and fertility-Time to apply facts learned at the bench to help the patient: Lessons for busy clinicians","volume":"23","author":"Sengupta","year":"2024","journal-title":"Reprod. Med. Biol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Wang, Y., Fu, X., and Li, H. (2025). Mechanisms of oxidative stress-induced sperm dysfunction. Front. Endocrinol., 16.","DOI":"10.3389\/fendo.2025.1520835"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Potiris, A., Moustakli, E., Trismpioti, E., Drakaki, E., Mavrogianni, D., Matsas, A., Zikopoulos, A., Sfakianakis, A., Tsakiridis, I., and Dagklis, T. (2025). From Inflammation to Infertility: How Oxidative Stress and Infections Disrupt Male Reproductive Health. Metabolites, 15.","DOI":"10.3390\/metabo15040267"},{"key":"ref_8","first-page":"123","article-title":"Impact of Inflammation on Male Reproductive Tract","volume":"16","author":"Azenabor","year":"2015","journal-title":"J. Reprod. Infertil."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Zhan, M.W., Zhou, M.H., Zhao, B.B., Bao, X.J., Chen, Y., and Zhu, J. (2025). Testicular immunosenescence: A key player in age-related spermatogenic decline. Front. Cell Dev. Biol., 13.","DOI":"10.3389\/fcell.2025.1669826"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.jri.2015.02.001","article-title":"Cytokines in the male reproductive tract and their role in infertility disorders","volume":"108","author":"Fraczek","year":"2015","journal-title":"J. Reprod. Immunol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Manful, C.F., Fordjour, E., Ikumoinein, E., Abbey, L., and Thomas, R. (2025). Therapeutic Strategies Targeting Oxidative Stress and Inflammation: A Narrative Review. BioChem, 5.","DOI":"10.3390\/biochem5040035"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Mottola, F., Palmieri, I., Carannante, M., Barretta, A., Roychoudhury, S., and Rocco, L. (2024). Oxidative Stress Biomarkers in Male Infertility: Established Methodologies and Future Perspectives. Genes, 15.","DOI":"10.3390\/genes15050539"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"103622","DOI":"10.1016\/j.rbmo.2023.103622","article-title":"A systematic review identifying seminal plasma biomarkers and their predictive ability on IVF and ICSI outcomes","volume":"48","author":"Molina","year":"2024","journal-title":"Reprod. Biomed. Online"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1007\/s00404-025-08184-3","article-title":"Reductive stress and the role of antioxidants in male infertility: A narrative review","volume":"312","author":"Moustakli","year":"2025","journal-title":"Arch. Gynecol. Obstetrics"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1080\/2090598X.2019.1599624","article-title":"Oxidative stress and sperm function: A systematic review on evaluation and management","volume":"17","author":"Dutta","year":"2019","journal-title":"Arab. J. Urol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/S0015-0282(02)04948-8","article-title":"Role of reactive oxygen species in the pathophysiology of human reproduction","volume":"79","author":"Agarwal","year":"2003","journal-title":"Fertil. Steril."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Mo, L., Wu, H., Zhang, M., Zhang, P., Peng, W., He, Y., and Gao, F. (2025). The mechanism of oxidative stress in asthenozoospermia and antioxidant strategies: A review. Front. Endocrinol., 16.","DOI":"10.3389\/fendo.2025.1670762"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Chimento, A., De Luca, A., Venditti, M., De Amicis, F., and Pezzi, V. (2025). Beneficial Effects of Resveratrol on Testicular Functions: Focus on Its Antioxidant Properties. Cells, 14.","DOI":"10.3390\/cells14141122"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Gualtieri, R., Kalthur, G., Barbato, V., Longobardi, S., Di Rella, F., Adiga, S.K., and Talevi, R. (2021). Sperm Oxidative Stress during In Vitro Manipulation and Its Effects on Sperm Function and Embryo Development. Antioxidants, 10.","DOI":"10.3390\/antiox10071025"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"191","DOI":"10.5534\/wjmh.210063","article-title":"Relevance of Leukocytospermia and Semen Culture and Its True Place in Diagnosing and Treating Male Infertility","volume":"40","author":"Sharma","year":"2022","journal-title":"World J. Men\u2019s Health"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Wang, K., Gao, Y., Wang, C., Liang, M., Liao, Y., and Hu, K. (2022). Role of Oxidative Stress in Varicocele. Front. Genet., 13.","DOI":"10.3389\/fgene.2022.850114"},{"key":"ref_22","first-page":"e42583","article-title":"The Impact of Oxidative Stress on Male Reproductive Function: Exploring the Role of Antioxidant Supplementation","volume":"15","author":"Walke","year":"2023","journal-title":"Cureus"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"102071","DOI":"10.1016\/j.redox.2021.102071","article-title":"Male subfertility and oxidative stress","volume":"46","author":"Evans","year":"2021","journal-title":"Redox Biol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Xue, S.H., Xu, B.B., Yan, X.C., Zhang, J.X., and Su, R. (2025). Sperm Membrane Stability: In-Depth Analysis from Structural Basis to Functional Regulation. Vet. Sci., 12.","DOI":"10.3390\/vetsci12070658"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Onochie, C., Evi, K., and O\u2019Flaherty, C. (2025). Role of Redox-Induced Protein Modifications in Spermatozoa in Health and Disease. Antioxidants, 14.","DOI":"10.3390\/antiox14060720"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"103027","DOI":"10.1016\/j.dnarep.2020.103027","article-title":"Towards a comprehensive view of 8-oxo-7,8-dihydro-2\u2032-deoxyguanosine: Highlighting the intertwined roles of DNA damage and epigenetics in genomic instability","volume":"97","author":"Gorini","year":"2021","journal-title":"DNA Repair."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Chiorcea-Paquim, A.M. (2022). 8-oxoguanine and 8-oxodeoxyguanosine Biomarkers of Oxidative DNA Damage: A Review on HPLC-ECD Determination. Molecules, 27.","DOI":"10.3390\/molecules27051620"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/s43032-024-01714-5","article-title":"Perspective in the Mechanisms for Repairing Sperm DNA Damage","volume":"32","author":"Li","year":"2025","journal-title":"Reprod. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Candela, L., Boeri, L., Capogrosso, P., Cazzaniga, W., Pozzi, E., Belladelli, F., Baudo, A., Ravizzoli, A., Ventimiglia, E., and Vigan\u00f2, P. (2021). Correlation among isolated teratozoospermia, sperm DNA fragmentation and markers of systemic inflammation in primary infertile men. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0251608"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Gill, K., Machalowski, T., Harasny, P., Kups, M., Grabowska, M., Duchnik, E., Sipak, O., Fraczek, M., Kurpisz, M., and Kurzawa, R. (2022). Male Infertility Coexists with Decreased Sperm Genomic Integrity and Oxidative Stress in Semen Irrespective of Leukocytospermia. Antioxidants, 11.","DOI":"10.3390\/antiox11101987"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1111\/andr.13556","article-title":"Low human sperm motility coexists with sperm nuclear DNA damage and oxidative stress in semen","volume":"12","author":"Gill","year":"2024","journal-title":"Andrology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"10526","DOI":"10.1038\/s41598-025-95820-2","article-title":"Mitochondrial specific antioxidant MitoPBN mitigates oxidative stress and improves mitochondrial function in cryopreserved ram sperm","volume":"15","author":"Mehdipour","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Agarwal, A., Maldonado Rosas, I., Anagnostopoulou, C., Cannarella, R., Boitrelle, F., Munoz, L.V., Finelli, R., Durairajanayagam, D., Henkel, R., and Saleh, R. (2022). Oxidative Stress and Assisted Reproduction: A Comprehensive Review of Its Pathophysiological Role and Strategies for Optimizing Embryo Culture Environment. Antioxidants, 11.","DOI":"10.3390\/antiox11030477"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1111\/j.1439-0272.2010.01111.x","article-title":"Seminal plasma reactive oxygen species-antioxidants relationship with varicocele grade","volume":"44","author":"Mostafa","year":"2012","journal-title":"Andrologia"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Nowicka-Bauer, K., and Nixon, B. (2020). Molecular Changes Induced by Oxidative Stress that Impair Human Sperm Motility. Antioxidants, 9.","DOI":"10.3390\/antiox9020134"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1007\/978-3-030-89340-8_10","article-title":"Oxidative Stress and Varicocele-Associated Male Infertility","volume":"1358","author":"Lai","year":"2022","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1093\/humrep\/dei429","article-title":"Increased sperm DNA damage in patients with varicocele: Relationship with seminal oxidative stress","volume":"21","author":"Smith","year":"2006","journal-title":"Hum. Reprod."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e230024","DOI":"10.1530\/RAF-23-0024","article-title":"Role of oxidative stress in male infertility","volume":"4","author":"Takalani","year":"2023","journal-title":"Reprod. Fertil."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1007\/s12192-017-0855-0","article-title":"Testicular torsion and reperfusion: Evidences for biochemical and molecular alterations","volume":"23","author":"Razi","year":"2018","journal-title":"Cell Stress Chaperones"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Osadchuk, L., Kleshchev, M., and Osadchuk, A. (2023). Effects of cigarette smoking on semen quality, reproductive hormone levels, metabolic profile, zinc and sperm DNA fragmentation in men: Results from a population-based study. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1255304"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.ijheh.2014.08.006","article-title":"Effect of cigarette smoke on DNA damage, oxidative stress, and morphological alterations in mouse testis and spermatozoa","volume":"218","author":"Micale","year":"2015","journal-title":"Int. J. Hyg. Environ. Health"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"4281","DOI":"10.3390\/ijerph7124281","article-title":"Cellular and mitochondrial effects of alcohol consumption","volume":"7","year":"2010","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Sciorio, R., Greco, P.F., Greco, E., Tramontano, L., Elshaer, F.M., and Fleming, S. (2025). Potential effects of environmental toxicants on sperm quality and potential risk for fertility in humans. Front. Endocrinol., 16.","DOI":"10.3389\/fendo.2025.1545593"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1007\/s42452-025-07400-8","article-title":"Impacts of environmental pollutants and environmentally transmitted parasites on male fertility and sperm quality","volume":"7","author":"Mansour","year":"2025","journal-title":"Discov. Appl. Sci."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"101708","DOI":"10.1016\/j.toxrep.2024.101708","article-title":"Impact of air pollution and heavy metal exposure on sperm quality: A clinical prospective research study","volume":"13","author":"Abilash","year":"2024","journal-title":"Toxicol. Rep."},{"key":"ref_46","first-page":"204","article-title":"The association between dietary antioxidant intake and semen quality in infertile men","volume":"27","author":"Nadjarzadeh","year":"2013","journal-title":"Med. J. Islam. Repub. Iran"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"3321","DOI":"10.1111\/febs.17366","article-title":"Exploring the interplay between inflammation and male fertility","volume":"292","author":"Fomichova","year":"2025","journal-title":"FEBS J."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"531","DOI":"10.4103\/aja.aja_11_19","article-title":"The epididymal immune balance: A key to preserving male fertility","volume":"21","author":"Voisin","year":"2019","journal-title":"Asian J. Androl."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1007\/s12016-021-08907-9","article-title":"Role of Inflammaging on the Reproductive Function and Pregnancy","volume":"64","author":"Zavatta","year":"2023","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"156718","DOI":"10.1016\/j.cyto.2024.156718","article-title":"Analysis of 12 kinds of cytokines in seminal plasma by flow cytometry and their correlations with routine semen parameters","volume":"182","author":"Tang","year":"2024","journal-title":"Cytokine"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Moreira, R.J., Oliveira, P.F., Spadella, M.A., Ferreira, R., and Alves, M.G. (2025). Do Lifestyle Interventions Mitigate the Oxidative Damage and Inflammation Induced by Obesity in the Testis?. Antioxidants, 14.","DOI":"10.3390\/antiox14020150"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Henkel, R. (2024). Leukocytospermia and\/or Bacteriospermia: Impact on Male Infertility. J. Clin. Med., 13.","DOI":"10.3390\/jcm13102841"},{"key":"ref_53","first-page":"470","article-title":"Impact of leukocytospermia on sperm dynamic motility parameters, DNA and chromosomal integrity","volume":"71","author":"Moubasher","year":"2018","journal-title":"Cent. Eur. J. Urol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"182","DOI":"10.4103\/jhrs.JHRS_1_19","article-title":"Sperm DNA Integrity in Leukocytospermia and Its Association with Seminal Adenosine Deaminase","volume":"12","author":"Pratap","year":"2019","journal-title":"J. Hum. Reprod. Sci."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1186\/s12985-024-02431-w","article-title":"Correlation between viral infections in male semen and infertility: A literature review","volume":"21","author":"Guo","year":"2024","journal-title":"Virol. J."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1055\/s-0036-1586143","article-title":"The Varicocele: Clinical Presentation, Evaluation, and Surgical Management","volume":"33","author":"Lomboy","year":"2016","journal-title":"Semin. Interv. Radiol."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Casas-Deza, D., Garc\u00eda-L\u00f3pez, S., Bernal-Monterde, V., Polo-Cuadro, C., Yag\u00fce-Caballero, C., and Arbones-Mainar, J.M. (2025). Obesity-Mediated Inflammation and Its Influence on Inflammatory Bowel Disease: Pathophysiology, Clinical Impact, and Therapeutic Implications. Biomolecules, 15.","DOI":"10.3390\/biom15081185"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Hasan, H., Bhushan, S., Fijak, M., and Meinhardt, A. (2022). Mechanism of Inflammatory Associated Impairment of Sperm Function, Spermatogenesis and Steroidogenesis. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.897029"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Sciorio, R., De Paola, L., Notari, T., Ganduscio, S., Amato, P., Crifasi, L., Marotto, D., Billone, V., Cucinella, G., and Perino, A. (2025). Decoding the Puzzle of Male Infertility: The Role of Infection, Inflammation, and Autoimmunity. Diagnostics, 15.","DOI":"10.3390\/diagnostics15050547"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.semcdb.2014.02.011","article-title":"Sertoli cells\u2014Immunological sentinels of spermatogenesis","volume":"30","author":"Kaur","year":"2014","journal-title":"Semin. Cell Dev. Biol."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Ye, L., Huang, W., Liu, S., Cai, S., Hong, L., Xiao, W., Thiele, K., Zeng, Y., Song, M., and Diao, L. (2021). Impacts of Immunometabolism on Male Reproduction. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.658432"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1038\/cmi.2014.38","article-title":"Testicular defense systems: Immune privilege and innate immunity","volume":"11","author":"Zhao","year":"2014","journal-title":"Cell. Mol. Immunol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"380","DOI":"10.5534\/wjmh.210164","article-title":"Antisperm Antibody Testing: A Comprehensive Review of Its Role in the Management of Immunological Male Infertility and Results of a Global Survey of Clinical Practices","volume":"40","author":"Gupta","year":"2022","journal-title":"World J. Men\u2019s Health"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"8742","DOI":"10.1038\/s41467-025-63514-y","article-title":"Chronic inflammation drives epididymal tertiary lymphoid structure formation and autoimmune fertility disorders in mice","volume":"16","author":"Elizagaray","year":"2025","journal-title":"Nat. Commun."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"471","DOI":"10.3390\/pathophysiology28040030","article-title":"Pathogenesis of Autoimmune Male Infertility: Juxtacrine, Paracrine, and Endocrine Dysregulation","volume":"28","author":"Chereshnev","year":"2021","journal-title":"Pathophysiology"},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Haratian, K., Faegh, A., Mehrpoor, G., Doustmohammadi, M., Rezaeinasab, R., and MomeniAmjadi, A. (2025). Potential causes and associated conditions with anti-sperm antibody production among infertile males: A systematic literature review. BMC Immunol., 26.","DOI":"10.1186\/s12865-025-00740-5"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Kici\u0144ska, A.M., Maksym, R.B., Zabielska-Kaczorowska, M.A., Stachowska, A., and Babi\u0144ska, A. (2023). Immunological and Metabolic Causes of Infertility in Polycystic Ovary Syndrome. Biomedicines, 11.","DOI":"10.3390\/biomedicines11061567"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1111\/andr.13772","article-title":"Immunoregulation and male reproductive function: Impacts and mechanistic insights into inflammation","volume":"13","author":"Ma","year":"2025","journal-title":"Andrology"},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Loveland, K.L., Klein, B., Pueschl, D., Indumathy, S., Bergmann, M., Loveland, B.E., Hedger, M.P., and Schuppe, H.-C. (2017). Cytokines in Male Fertility and Reproductive Pathologies: Immunoregulation and Beyond. Front. Endocrinol., 8.","DOI":"10.3389\/fendo.2017.00307"},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Zhou, J., Hu, S., Ouyang, Y., Kong, Y., and Liu, M. (2025). Immunometabolism and male reproductive function: Linking inflammation, oxidative stress, and declining fertility. Front. Immunol., 16.","DOI":"10.3389\/fimmu.2025.1736492"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"e13743","DOI":"10.1111\/and.13743","article-title":"The role of infections and leukocytes in male infertility","volume":"53","author":"Henkel","year":"2021","journal-title":"Andrologia"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s12610-025-00268-z","article-title":"From imaging techniques to laboratory tests: A multimodal stratification for varicocele-associated decreased semen quality","volume":"35","author":"Wang","year":"2025","journal-title":"Basic Clin. Androl."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s43043-022-00099-2","article-title":"Obesity and male infertility: Multifaceted reproductive disruption","volume":"27","author":"Chaudhuri","year":"2022","journal-title":"Middle East Fertil. Soc. J."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"253","DOI":"10.4161\/spmg.21362","article-title":"Impact of obesity on male fertility, sperm function and molecular composition","volume":"2","author":"Palmer","year":"2012","journal-title":"Spermatogenesis"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1111\/andr.13552","article-title":"Male obesity: Associated effects on fertility and the outcomes of offspring","volume":"13","author":"Venigalla","year":"2025","journal-title":"Andrology"},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Bellanti, F., Coda, A.R.D., Trecca, M.I., Lo Buglio, A., Serviddio, G., and Vendemiale, G. (2025). Redox Imbalance in Inflammation: The Interplay of Oxidative and Reductive Stress. Antioxidants, 14.","DOI":"10.3390\/antiox14060656"},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Hussain, T., Kandeel, M., Metwally, E., Murtaza, G., Kalhoro, D.H., Yin, Y., Tan, B., Chughtai, M.I., Yaseen, A., and Afzal, A. (2023). Unraveling the harmful effect of oxidative stress on male fertility: A mechanistic insight. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1070692"},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Michalak, K.P., and Michalak, A.Z. (2025). Understanding chronic inflammation: Couplings between cytokines, ROS, NO, Cai2+, HIF-1\u03b1, Nrf2 and autophagy. Front. Immunol., 16.","DOI":"10.3389\/fimmu.2025.1558263"},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Leiba, J., \u00d6zbilgi\u00e7, R., Hern\u00e1ndez, L., Demou, M., Lutfalla, G., Yatime, L., and Nguyen-Chi, M. (2023). Molecular Actors of Inflammation and Their Signaling Pathways: Mechanistic Insights from Zebrafish. Biology, 12.","DOI":"10.3390\/biology12020153"},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Krzy\u015bciak, W., Papie\u017c, M., B\u0105k, E., Morava, E., Krzy\u015bciak, P., Lig\u0119zka, A., Gniadek, A., Vyhouskaya, P., and Janeczko, J. (2020). Sperm Antioxidant Biomarkers and Their Correlation with Clinical Condition and Lifestyle with Regard to Male Reproductive Potential. J. Clin. Med., 9.","DOI":"10.3390\/jcm9061785"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.aju.2017.11.008","article-title":"Laboratory assessment of oxidative stress in semen","volume":"16","author":"Agarwal","year":"2018","journal-title":"Arab. J. Urol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/j.toxrep.2023.04.006","article-title":"Apoptosis, inflammation, and oxidative stress in infertility: A mini review","volume":"10","author":"Ojo","year":"2023","journal-title":"Toxicol. Rep."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s12301-020-00061-6","article-title":"Impact of oxidative stress on semen parameters in normozoospermic infertile men: A case\u2013control study","volume":"26","author":"Palani","year":"2020","journal-title":"Afr. J. Urol."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Bruno, C., Basile, U., Vergani, E., Napodano, C., Oliva, A., Gulli, F., Meucci, E., Silvestrini, A., Orlando, P., and Silvestri, S. (2022). Inflammation and Oxidative Stress in Seminal Plasma: Search for Biomarkers in Diagnostic Approach to Male Infertility. J. Pers. Med., 12.","DOI":"10.3390\/jpm12060857"},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Moustakli, E., Zikopoulos, A., Katopodis, P., Dafopoulos, S., Paraschos, V.S., Zachariou, A., and Dafopoulos, K. (2025). Dietary and Lifestyle Interventions to Mitigate Oxidative Stress in Male and Female Fertility: Practical Insights for Infertility Management\u2014A Narrative Review. Metabolites, 15.","DOI":"10.3390\/metabo15060379"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/s00018-019-03253-8","article-title":"Oxidative stress and male infertility: Current knowledge of pathophysiology and role of antioxidant therapy in disease management","volume":"77","author":"Barati","year":"2020","journal-title":"Cell. Mol. Life Sci."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1111\/cen.14328","article-title":"Baseline levels of seminal reactive oxygen species predict improvements in sperm function following antioxidant therapy in men with infertility","volume":"94","author":"Vessey","year":"2021","journal-title":"Clin. Endocrinol."},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Polj\u0161ak, B., Jamnik, P., and Milisav, I. (2025). The Importance of Multifaceted Approach for Accurate and Comprehensive Evaluation of Oxidative Stress Status in Biological Systems. Antioxidants, 14.","DOI":"10.3390\/antiox14091083"},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Gambini, J., and Stromsnes, K. (2022). Oxidative Stress and Inflammation: From Mechanisms to Therapeutic Approaches. Biomedicines, 10.","DOI":"10.3390\/biomedicines10040753"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1016\/j.jsps.2023.05.007","article-title":"Samarcandin protects against testicular ischemia\/reperfusion injury in rats via activation of Nrf2\/HO-1-mediated antioxidant responses","volume":"31","author":"Althurwi","year":"2023","journal-title":"Saudi Pharm. J."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.jri.2003.10.005","article-title":"Male genital tract infection: An influence of leukocytes and bacteria on semen","volume":"62","author":"Sanocka","year":"2004","journal-title":"J. Reprod. Immunol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1557988320970053","DOI":"10.1177\/1557988320970053","article-title":"Reactive Oxygen Species Secreted by Leukocytes in Semen Induce Self-Expression of Interleukin-6 and Affect Sperm Quality","volume":"14","author":"Li","year":"2020","journal-title":"Am. J. Men\u2019s Health"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.jri.2013.09.005","article-title":"In vitro reconstruction of inflammatory reaction in human semen: Effect on sperm DNA fragmentation","volume":"100","author":"Fraczek","year":"2013","journal-title":"J. Reprod. Immunol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"102101","DOI":"10.1016\/j.jogoh.2021.102101","article-title":"Relationship between nuclear DNA fragmentation, mitochondrial DNA damage and standard sperm parameters in spermatozoa of infertile patients with leukocytospermia","volume":"50","author":"Derbel","year":"2021","journal-title":"J. Gynecol. Obstet. Hum. Reprod."},{"key":"ref_95","doi-asserted-by":"crossref","unstructured":"Odetayo, A.F., Adeyemi, W.J., and Olayaki, L.A. (2023). Omega-3 fatty acid ameliorates bisphenol F-induced testicular toxicity by modulating Nrf2\/NFkB pathway and apoptotic signaling. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1256154"},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Hibaoui, Y., Khedhri, S., Wunder, D., Vargas, J., Vall\u00e9e, A., Ayoubi, J.M., and Feki, A. (2025). Determination of the Antioxidant Capacity of Human Seminal Fluid Using a Fast and Accurate Electrochemical Approach. Antioxidants, 15.","DOI":"10.3390\/antiox15010035"},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Gill, K., Kups, M., Harasny, P., Machalowski, T., Grabowska, M., Lukaszuk, M., Matuszewski, M., Duchnik, E., Fraczek, M., and Kurpisz, M. (2021). The Negative Impact of Varicocele on Basic Semen Parameters, Sperm Nuclear DNA Dispersion and Oxidation-Reduction Potential in Semen. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18115977"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1007\/s10815-016-0756-7","article-title":"Association of semen cytokines with reactive oxygen species and histone transition abnormalities","volume":"33","author":"Jiang","year":"2016","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"e14023","DOI":"10.1111\/and.14023","article-title":"Sperm DNA damage and cytokines in varicocele: A case-control study","volume":"53","author":"Finelli","year":"2021","journal-title":"Andrologia"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"e14322","DOI":"10.1111\/and.14322","article-title":"The relationship between genitourinary microorganisms and oxidative stress, sperm DNA fragmentation and semen parameters in infertile men","volume":"54","author":"Ho","year":"2022","journal-title":"Andrologia"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1111\/andr.12296","article-title":"Metabolic syndrome and the seminal cytokine network in morbidly obese males","volume":"5","author":"Pilatz","year":"2017","journal-title":"Andrology"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.5713\/ab.21.0072","article-title":"Semen evaluation: Methodological advancements in sperm quality-specific fertility assessment\u2014A review","volume":"34","author":"Tanga","year":"2021","journal-title":"Anim. Biosci."},{"key":"ref_103","doi-asserted-by":"crossref","unstructured":"Wang, F., Yang, W., Ouyang, S., and Yuan, S. (2020). The Vehicle Determines the Destination: The Significance of Seminal Plasma Factors for Male Fertility. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21228499"},{"key":"ref_104","first-page":"137","article-title":"Association between a marker of sperm DNA damage and sperm indices in infertile males in Benin City, Nigeria: A cross-sectional study","volume":"19","author":"Yusuf","year":"2021","journal-title":"Int. J. Reprod. Biomed."},{"key":"ref_105","doi-asserted-by":"crossref","unstructured":"Ball\u00f3, A., Cz\u00e9t\u00e1ny, P., Buszny\u00e1kn\u00e9, K.S., M\u00e1rk, L., Mike, N., T\u00f6r\u00f6k, A., Sz\u00e1nt\u00f3, \u00c1., and M\u00e1t\u00e9, G. (2023). Oxido-Reduction Potential as a Method to Determine Oxidative Stress in Semen Samples. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms241511981"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1111\/andr.12743","article-title":"Predictive value of oxidative stress testing in semen for sperm DNA fragmentation assessed by sperm chromatin dispersion test","volume":"8","author":"Elbardisi","year":"2020","journal-title":"Andrology"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1080\/13510002.2018.1456000","article-title":"Optimization of a diagnostic platform for oxidation-reduction potential (ORP) measurement in human plasma","volume":"23","author":"Polson","year":"2018","journal-title":"Redox Rep."},{"key":"ref_108","doi-asserted-by":"crossref","unstructured":"Pavuluri, H., Bakhtiary, Z., Panner Selvam, M.K., and Hellstrom, W.J.G. (2024). Oxidative Stress-Associated Male Infertility: Current Diagnostic and Therapeutic Approaches. Medicina, 60.","DOI":"10.3390\/medicina60061008"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1007\/s10815-015-0454-x","article-title":"Reactive Oxygen Species (ROS) in human semen: Determination of a reference range","volume":"32","author":"Homa","year":"2015","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_110","doi-asserted-by":"crossref","unstructured":"Rochdi, C., Nasr, F.A., Elrherabi, A., Bellajdel, I., Taheri, H., Bouhrim, M., Al-Zharani, M., Qurtam, A.A., Saadi, H., and Mimouni, A. (2025). Correlation between semen quality and the seminal biochemical markers: Alpha-glucosidase, fructose, and zinc in infertile men compared with a normal population of men. Front. Endocrinol., 16.","DOI":"10.3389\/fendo.2025.1583272"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"e70179","DOI":"10.1002\/mco2.70179","article-title":"Alterations in Semen Quality and Immune-Related Factors in Men with Infertility who Recovered from COVID-19","volume":"6","author":"Zhang","year":"2025","journal-title":"MedComm"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"36","DOI":"10.3390\/uro4020004","article-title":"The Clinical Management of Leukocytospermia in Male Infertility: A Narrative Review","volume":"4","author":"Hussain","year":"2024","journal-title":"Uro"},{"key":"ref_113","doi-asserted-by":"crossref","unstructured":"Menzel, A., Samouda, H., Dohet, F., Loap, S., Ellulu, M.S., and Bohn, T. (2021). Common and Novel Markers for Measuring Inflammation and Oxidative Stress Ex Vivo in Research and Clinical Practice-Which to Use Regarding Disease Outcomes?. Antioxidants, 10.","DOI":"10.3390\/antiox10030414"},{"key":"ref_114","first-page":"e240571","article-title":"Association of leukocyte elastase in semen and seminal plasma with sperm parameters and pregnancy outcomes in male fertility","volume":"14","author":"Das","year":"2025","journal-title":"Endocr. Connect."},{"key":"ref_115","doi-asserted-by":"crossref","unstructured":"Rodak, K., Kokot, I., Faundez, R., Gilowska, I., and Kratz, E.M. (2025). Biomarkers and Mechanisms of Male Infertility: Evaluation of Antioxidant Enzymes and Arachidonic Acid Derivatives in Seminal Plasma from Fertile and Infertile Men. Antioxidants, 14.","DOI":"10.3390\/antiox14121470"},{"key":"ref_116","doi-asserted-by":"crossref","unstructured":"Neganova, M., Liu, J., Aleksandrova, Y., Klochkov, S., and Fan, R. (2021). Therapeutic Influence on Important Targets Associated with Chronic Inflammation and Oxidative Stress in Cancer Treatment. Cancers, 13.","DOI":"10.3390\/cancers13236062"},{"key":"ref_117","doi-asserted-by":"crossref","unstructured":"Moustakli, E., Zikopoulos, A., Skentou, C., Stavros, S., Sofikitis, N., Georgiou, I., and Zachariou, A. (2024). Integrative Assessment of Seminal Plasma Biomarkers: A Narrative Review Bridging the Gap between Infertility Research and Clinical Practice. J. Clin. Med., 13.","DOI":"10.3390\/jcm13113147"},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1038\/mp.2011.63","article-title":"Translating biomarkers to clinical practice","volume":"16","author":"Perlis","year":"2011","journal-title":"Mol. Psychiatry"},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"102035","DOI":"10.1016\/j.toxrep.2025.102035","article-title":"Advancing precision medicine: Uncovering biomarkers and strategies to mitigate immune-related adverse events in immune checkpoint inhibitors therapy","volume":"14","author":"Nityashree","year":"2025","journal-title":"Toxicol. Rep."},{"key":"ref_120","doi-asserted-by":"crossref","unstructured":"Dimitriadis, F., Borgmann, H., Struck, J.P., Salem, J., and Kuru, T.H. (2023). Antioxidant Supplementation on Male Fertility-A Systematic Review. Antioxidants, 12.","DOI":"10.3390\/antiox12040836"},{"key":"ref_121","doi-asserted-by":"crossref","unstructured":"Bouhadana, D., Godin Pag\u00e9, M.H., Montjean, D., B\u00e9langer, M.C., Benkhalifa, M., Miron, P., and Petrella, F. (2025). The Role of Antioxidants in Male Fertility: A Comprehensive Review of Mechanisms and Clinical Applications. Antioxidants, 14.","DOI":"10.3390\/antiox14081013"},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"277","DOI":"10.5653\/cerm.2022.05463","article-title":"Coenzyme Q10 improves sperm motility and antioxidant status in infertile men with idiopathic oligoasthenospermia","volume":"49","author":"Alahmar","year":"2022","journal-title":"Clin. Exp. Reprod. Med."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"116565","DOI":"10.1016\/j.bcp.2024.116565","article-title":"Carnitine traffic and human fertility","volume":"230","author":"Mazza","year":"2024","journal-title":"Biochem. Pharmacol."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1093\/advances\/nmy052","article-title":"Antioxidants in Personalized Nutrition and Exercise","volume":"9","author":"Margaritelis","year":"2018","journal-title":"Adv. Nutr."},{"key":"ref_125","doi-asserted-by":"crossref","unstructured":"Fratta Pasini, A.M., and Cominacini, L. (2021). Effect of Antioxidant Therapy on Oxidative Stress In Vivo. Antioxidants, 10.","DOI":"10.3390\/antiox10030344"},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"14","DOI":"10.5534\/wjmh.220067","article-title":"Impact of Antioxidant Therapy on Natural Pregnancy Outcomes and Semen Parameters in Infertile Men: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"41","author":"Agarwal","year":"2023","journal-title":"World J. Men\u2019s Health"},{"key":"ref_127","doi-asserted-by":"crossref","unstructured":"Feng, R., Cheng, D., Zhang, W., Zhang, J., Chen, S., and Xia, Y. (2025). Immune Microenvironment Dysregulation: A Contributing Factor to Obesity-Associated Male Infertility. Biomedicines, 13.","DOI":"10.3390\/biomedicines13061314"},{"key":"ref_128","first-page":"e37080","article-title":"Effects of Non-steroidal Anti-inflammatory Drugs (NSAIDs) and Gastroprotective NSAIDs on the Gastrointestinal Tract: A Narrative Review","volume":"15","author":"Sohail","year":"2023","journal-title":"Cureus"},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"239","DOI":"10.4103\/1008-682X.172639","article-title":"Summary evidence on the effects of varicocele treatment to improve natural fertility in subfertile men","volume":"18","author":"Tiseo","year":"2016","journal-title":"Asian J. Androl."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"87","DOI":"10.5534\/wjmh.210153","article-title":"Oxidative Stress: A Comprehensive Review of Biochemical, Molecular, and Genetic Aspects in the Pathogenesis and Management of Varicocele","volume":"40","author":"Finelli","year":"2022","journal-title":"World J. Men\u2019s Health"},{"key":"ref_131","doi-asserted-by":"crossref","unstructured":"Kliber-Ga\u0142uszka, M., Kulczy\u0144ska-Figurny, K., Jagodzi\u0144ski, P.P., and P\u0142awski, A. (2025). Potential biomarkers for early detection of endometriosis: Current state of art (what we know so far). J. Appl. Genet.","DOI":"10.1007\/s13353-025-01021-y"},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1590\/s1677-5538.ibju.2021.0604","article-title":"The combined effect of lifestyle intervention and antioxidant therapy on sperm DNA fragmentation and seminal oxidative stress in IVF patients: A pilot study","volume":"48","author":"Humaidan","year":"2022","journal-title":"Int. Braz. J. Urol. Off. J. Braz. Soc. Urol."},{"key":"ref_133","doi-asserted-by":"crossref","unstructured":"Nani, A., Murtaza, B., Sayed Khan, A., Khan, N.A., and Hichami, A. (2021). Antioxidant and Anti-Inflammatory Potential of Polyphenols Contained in Mediterranean Diet in Obesity: Molecular Mechanisms. Molecules, 26.","DOI":"10.3390\/molecules26040985"},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1097\/MOU.0000000000001056","article-title":"Medical management of male infertility: Now and future","volume":"33","author":"Chen","year":"2023","journal-title":"Curr. Opin. Urol."},{"key":"ref_135","doi-asserted-by":"crossref","unstructured":"Jiers, W., Sommerfeld-Klatta, K., Gumustas, M., Mozdziak, P., \u0141ukasik-G\u0142\u0119bocka, M., Te\u017cyk, A., \u017baba, Z., \u017baba, C., and Piotrowska-Kempisty, H. (2025). Analytical Biomarkers for Inflammation Status Monitoring of Psychotropic and Antiepileptic Drugs. Pharmaceuticals, 18.","DOI":"10.3390\/ph18081213"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/4\/527\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T12:24:35Z","timestamp":1770726275000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/4\/527"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,10]]},"references-count":135,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["diagnostics16040527"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16040527","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,10]]}}}