{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T17:12:31Z","timestamp":1788023551382,"version":"build-2784847793"},"reference-count":54,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T00:00:00Z","timestamp":1756857600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Scientific Research Projects Unit of Maltepe University","award":["123S891"],"award-info":[{"award-number":["123S891"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>The chemotherapeutic combination of bleomycin, etoposide, and cisplatin (BEP) is well-documented to exert gonadotoxic effects, ultimately leading to impaired fertility. This experimental rat study investigated the potential protective role of repeated medical ozone therapy in mitigating the deleterious effects of BEP treatment in male rats. Thirty-two adult male Sprague Dawley rats were randomly assigned to four groups: (i) a healthy control group, (ii) a group receiving injections of the BEP regimen over nine weeks, (iii) a group receiving the same BEP regimen plus medical ozone (1 mg\/kg IP) twice weekly, and (iv) a group receiving only ozone therapy. BEP treatment significantly reduced sperm concentration and increased morphological abnormalities, both of which were partially restored by ozone co-administration. Ozone therapy also elevated testosterone and thyroid-stimulating hormone (TSH) levels when co-administered with BEP compared to BEP treatment alone. Oxidative stress analysis demonstrated that total oxidative status (TOS) and total antioxidant status (TAS) levels were significantly improved in the BEP + ozone group. Histopathological analysis revealed that ozone treatment ameliorated BEP-induced testicular damage, as evidenced by improved Johnsen scores and increased thickness of the seminiferous tubule epithelium. In conclusion, repeated medical ozone therapy appears to mitigate BEP-induced reproductive toxicity by preserving sperm quality, endocrine function, and redox homeostasis.<\/jats:p>","DOI":"10.3390\/ijms26178547","type":"journal-article","created":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T08:04:15Z","timestamp":1756886655000},"page":"8547","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Medical Ozone Treatment Attenuates Male Reproductive Toxicity Induced by Bleomycin, Etoposide, and Cisplatin Regimen in an Experimental Animal Model"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6837-068X","authenticated-orcid":false,"given":"Necdet","family":"Alt\u0131ner","sequence":"first","affiliation":[{"name":"Department of Histology and Embryology, Faculty of Medicine, Maltepe University, 34858 Istanbul, T\u00fcrkiye"},{"name":"Experimental Animals Research and Application Center, Maltepe University, 34858 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4605-1167","authenticated-orcid":false,"given":"Yaprak","family":"D\u00f6nmez \u00c7ak\u0131l","sequence":"additional","affiliation":[{"name":"Department of Medical Biology and Genetics, Faculty of Medicine, Maltepe University, 34858 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7818-491X","authenticated-orcid":false,"given":"\u0130dil","family":"Duran","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Maltepe University, 34858 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0674-090X","authenticated-orcid":false,"given":"Damla G\u00f6k\u00e7eo\u011flu","family":"Kayal\u0131","sequence":"additional","affiliation":[{"name":"Histology and Embryology Department, Marmara University School of Medicine, 34854 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6104-8820","authenticated-orcid":false,"given":"Hale","family":"Bayram","sequence":"additional","affiliation":[{"name":"Department of Histology and Embryology, Faculty of Medicine, Maltepe University, 34858 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4419-5458","authenticated-orcid":false,"given":"Abdullah","family":"Pehlivan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Maltepe University, 34857 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O\u011fuz Kaan","family":"Tombul","sequence":"additional","affiliation":[{"name":"Experimental Animals Research and Application Center, Maltepe University, 34858 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4478-7514","authenticated-orcid":false,"given":"Belgin","family":"Selam","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, Acibadem Mehmet Ali Aydinlar University, 34638 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"C\u0131nc\u0131k","sequence":"additional","affiliation":[{"name":"Department of Histology and Embryology, Faculty of Medicine, Maltepe University, 34858 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa Erin\u00e7","family":"Sitar","sequence":"additional","affiliation":[{"name":"Experimental Animals Research and Application Center, Maltepe University, 34858 Istanbul, T\u00fcrkiye"},{"name":"Department of Clinical Biochemistry, Faculty of Medicine, Maltepe University, 34858 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Ujah, G.A., Nna, V.U., Suleiman, J.B., Eleazu, C., Nwokocha, C., Rebene, J.A., Imowo, M.U., Obi, E.O., Amachree, C., and Udechukwu, E.C. (2021). Tert-butylhydroquinone attenuates doxorubicin-induced dysregulation of testicular cytoprotective and steroidogenic genes, and improves spermatogenesis in rats. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-85026-7"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Moradi, M., Hashemian, M.A., Faramarzi, A., Goodarzi, N., Hashemian, A.H., Cheraghi, H., and Jalili, C. (2024). Therapeutic effect of sodium alginate on bleomycin, etoposide and cisplatin (BEP)-induced reproductive toxicity by inhibiting nitro-oxidative stress, inflammation and apoptosis. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-52010-w"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"32","DOI":"10.4274\/jus.galenos.2018.2225","article-title":"Does Ozone Administration Have a Protective Effect Against Cisplatin induced Histological Changes in Rat Testis?","volume":"6","author":"Ekin","year":"2019","journal-title":"J. Urol. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2597","DOI":"10.1200\/JCO.2006.05.6184","article-title":"Bleomycin, Etoposide, and Cisplatin for Three Cycles Compared With Etoposide and Cisplatin for Four Cycles in Good-Risk Germ Cell Tumors: Is There a Preferred Regimen?","volume":"24","author":"Einhorn","year":"2006","journal-title":"J. Clin. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"641","DOI":"10.2165\/00003495-200666050-00005","article-title":"Advances in the treatment of testicular cancer","volume":"66","author":"Kopp","year":"2006","journal-title":"Drugs"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Zeien, J., Qiu, W., Triay, M., Dhaibar, H.A., Cruz-Topete, D., Cornett, E.M., Urits, I., Viswanath, O., and Kaye, A.D. (2022). Clinical implications of chemotherapeutic agent organ toxicity on perioperative care. Biomed. Pharmacother., 146.","DOI":"10.1016\/j.biopha.2021.112503"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"He, Y., Zheng, J., Ye, B., Dai, Y., and Nie, K. (2023). Chemotherapy-induced gastrointestinal toxicity: Pathogenesis and current management. Biochem. Pharmaco., 216.","DOI":"10.1016\/j.bcp.2023.115787"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1089\/wound.2023.0097","article-title":"Chemotherapy-Mediated Complications of Wound Healing: An Understudied Side Effect","volume":"13","author":"Sachadyn","year":"2024","journal-title":"Adv. Wound Care"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"4372719","DOI":"10.1155\/2020\/4372719","article-title":"Vitamin B17 ameliorates methotrexate-induced reproductive toxicity, oxidative stress, and testicular injury in male rats","volume":"2020","author":"Felemban","year":"2020","journal-title":"Oxidative Med. Cell. Longev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.ejphar.2011.11.025","article-title":"Molecular effects of chemotherapeutic drugs and their modulation by antioxidants in the testis","volume":"674","author":"Narayana","year":"2012","journal-title":"Eur. J. Pharmacol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"152528","DOI":"10.1016\/j.tox.2020.152528","article-title":"Tert-butylhydroquinone preserve testicular steroidogenesis and spermatogenesis in cisplatin-intoxicated rats by targeting oxidative stress, inflammation and apoptosis","volume":"441","author":"Nna","year":"2020","journal-title":"Toxicology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.ejphar.2014.12.006","article-title":"Effects of bleomycin, etoposide and cisplatin treatment on Leydig cell structure and transcription of steroidogenic enzymes in rat testis","volume":"747","author":"Kilarkaje","year":"2015","journal-title":"Eur. J. Pharmacol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Bayram, H., Donmez Cakil, Y., Sitar, M.E., Demirel, G., Selam, B., and Cincik, M. (2023). The Effects of Glutathione on Clinically Essential Fertility Parameters in a Bleomycin Etoposide Cisplatin Chemotherapy Model. Life, 13.","DOI":"10.3390\/life13030815"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1016\/j.fertnstert.2013.06.019","article-title":"Antioxidants enhance the recovery of three cycles of bleomycin, etoposide, and cisplatin-induced testicular dysfunction, pituitary-testicular axis, and fertility in rats","volume":"100","author":"Kilarkaje","year":"2013","journal-title":"Fertil. Steril."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Moradi, M., Goodarzi, N., Faramarzi, A., Cheraghi, H., Hashemian, A.H., and Jalili, C. (2021). Melatonin protects rats testes against bleomycin, etoposide, and cisplatin-induced toxicity via mitigating nitro-oxidative stress and apoptosis. Biomed. Pharmacother., 138.","DOI":"10.1016\/j.biopha.2021.111481"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"432","DOI":"10.2164\/jandrol.110.011601","article-title":"Effects of chemotherapeutic agents for testicular cancer on rat spermatogonial stem\/progenitor cells","volume":"32","author":"Marcon","year":"2011","journal-title":"J. Androl."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1007\/s12672-024-01549-1","article-title":"Late side effects of testicular cancer and treatment: A comprehensive review","volume":"15","author":"Khan","year":"2024","journal-title":"Discov. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.theriogenology.2019.09.039","article-title":"Protective effects of zinc on rat sperm chromatin integrity involvement: DNA methylation, DNA fragmentation, ubiquitination and protamination after bleomycin etoposide and cis-platin treatment","volume":"142","author":"Khadivi","year":"2020","journal-title":"Theriogenology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e12603","DOI":"10.1111\/and.12603","article-title":"Therapeutic effect of ozone and rutin on adriamycin-induced testicular toxicity in an experimental rat model","volume":"49","author":"Salem","year":"2017","journal-title":"Andrologia"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/2045-9912-1-29","article-title":"Mechanisms of Action Involved in Ozone Therapy: Is Healing Induced via a Mild Oxidative Stress?","volume":"1","author":"Sagai","year":"2011","journal-title":"Med. Gas Res."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Franzini, M., Valdenassi, L., Pandolfi, S., Tirelli, U., Ricevuti, G., Simonetti, V., Berretta, M., Vaiano, F., and Chirumbolo, S. (2022). The biological activity of medical ozone in the hormetic range and the role of full expertise professionals. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.979076"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Gali\u00e8, M., Covi, V., Tabaracci, G., and Malatesta, M. (2019). The Role of Nrf2 in the Antioxidant Cellular Response to Medical Ozone Exposure. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20164009"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/j.arcmed.2005.08.006","article-title":"Scientific and medical aspects of ozone therapy. State of the art","volume":"37","author":"Bocci","year":"2006","journal-title":"Arch. Med. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1016\/j.arcmed.2007.03.005","article-title":"Can ozonetherapy be performed if the biochemistry of the process cannot be controlled?","volume":"38","author":"Bocci","year":"2007","journal-title":"Arch. Med. Res."},{"key":"ref_25","first-page":"464","article-title":"The protective effect of Ozone on the mice testicular damage induced by methotrexate","volume":"28","author":"Khorsandi","year":"2024","journal-title":"JBRA Assist. Reprod."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"176","DOI":"10.5935\/1518-0557.20200081","article-title":"The effects of ozone and melatonin on busulfan-induced testicular damage in mice","volume":"25","author":"Moghadam","year":"2021","journal-title":"JBRA Assist. Reprod."},{"key":"ref_27","unstructured":"(2025, August 18). Madrid Declaration on Ozone Therapy. Available online: https:\/\/ozonesociety.org\/wp-content\/uploads\/2016\/06\/Ozone-Therapy-Madrid_declaration.pdf."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Serra, M.E.G., Baeza-Noci, J., Mendes Abdala, C.V., Luvisotto, M.M., Bertol, C.D., and Anzolin, A.P. (2023). The role of ozone treatment as integrative medicine. An evidence and gap map. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.1112296"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Ghezzi, M., Berretta, M., Bottacin, A., Palego, P., Sartini, B., Cosci, I., Finos, L., Selice, R., Foresta, C., and Garolla, A. (2016). Impact of Bep or Carboplatin Chemotherapy on Testicular Function and Sperm Nucleus of Subjects with Testicular Germ Cell Tumor. Front. Pharmacol., 7.","DOI":"10.3389\/fphar.2016.00122"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/j.1742-7843.2011.00688.x","article-title":"Persistent Impairment of Testicular Histology and Sperm Motility in Adult Rats Treated with Cisplatin at Peri-Puberty: Cisplatin Effects In Post-Pubertal and Adult Rats","volume":"109","author":"Favareto","year":"2011","journal-title":"Basic Clin. Pharmacol. Toxicol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3959","DOI":"10.2147\/DDDT.S120014","article-title":"Dose-dependent effects of cisplatin on the severity of testicular injury in Sprague Dawley rats: Reactive oxygen species and endoplasmic reticulum stress","volume":"10","author":"Soni","year":"2016","journal-title":"Drug Des. Devel. Ther."},{"key":"ref_32","unstructured":"(2025, July 21). Treatment-Related Toxicity in Testicular Germ Cell Tumors\u2014UpToDate. Available online: https:\/\/www.uptodate.com\/contents\/treatment-related-toxicity-in-testicular-germ-cell-tumors#H12."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e13866","DOI":"10.1111\/cts.13866","article-title":"Alkylating agents-induced gonadotoxicity in prepubertal males: Insights on the clinical and preclinical front","volume":"17","author":"Sriram","year":"2024","journal-title":"Clin. Transl. Sci."},{"key":"ref_34","first-page":"209","article-title":"Protective effect of royal jelly on fertility and biochemical parameters in bleomycin-induced male rats","volume":"12","author":"Amirshahi","year":"2014","journal-title":"Iran. J. Reprod. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1093\/toxsci\/kfr307","article-title":"Epigenetic Alterations in Sperm DNA Associated with Testicular Cancer Treatment","volume":"125","author":"Chan","year":"2012","journal-title":"Toxicol. Sci."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Maselli, J., Hales, B.F., Chan, P., and Robaire, B. (2012). Exposure to Bleomycin, Etoposide, and Cis-Platinum Alters Rat Sperm Chromatin Integrity and Sperm Head Protein Profile1. Biol. Reprod., 86.","DOI":"10.1095\/biolreprod.111.098616"},{"key":"ref_37","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_38","doi-asserted-by":"crossref","unstructured":"Viebahn-Haensler, R., and Le\u00f3n Fern\u00e1ndez, O.S. (2023). Ozone as Redox Bioregulator in Preventive Medicine: The Molecular and Pharmacological Basis of the Low-Dose Ozone Concept\u2014A Review. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms242115747"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Franzini, M., Valdenassi, L., Pandolfi, S., Tirelli, U., Ricevuti, G., and Chirumbolo, S. (2023). The Role of Ozone as an Nrf2-Keap1-ARE Activator in the Anti-Microbial Activity and Immunity Modulation of Infected Wounds. Antioxidants, 12.","DOI":"10.3390\/antiox12111985"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1186\/s40001-024-01976-4","article-title":"Ozone therapy in musculoskeletal medicine: A comprehensive review","volume":"29","author":"Jeyaraman","year":"2024","journal-title":"Eur. J. Med. Res."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Malatesta, M., Tabaracci, G., and Pellicciari, C. (2024). Low-Dose Ozone as a Eustress Inducer: Experimental Evidence of the Molecular Mechanisms Accounting for Its Therapeutic Action. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms252312657"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.14744\/tjtes.2023.86086","article-title":"Is the increased ozone dosage key factor for its anti-inflammatory effect in an experimental model of mesenteric ischemia?","volume":"29","author":"Erginel","year":"2023","journal-title":"Turk. J. Trauma Emerg. Surg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e296","DOI":"10.1016\/j.wneu.2023.03.075","article-title":"Effect of Ozone Therapy on Epidural Fibrosis in Rats","volume":"175","author":"Simsek","year":"2023","journal-title":"World Neurosurg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1289\/ehp.8232","article-title":"Exposure to environmental ozone alters semen quality","volume":"114","author":"Sokol","year":"2006","journal-title":"Environ. Health Perspect."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1262\/jrd.17028","article-title":"Impact of oxidative stress and supplementation with vitamins E and C on testes morphology in rats","volume":"52","author":"Bomba","year":"2006","journal-title":"J. Reprod. Dev."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1590\/s1677-5538.ibju.2016.0546","article-title":"Medical ozone therapy reduces oxidative stress and testicular damage in an experimental model of testicular torsion in rats","volume":"43","author":"Tusat","year":"2017","journal-title":"Int. Braz. J. Urol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1080\/01902148.2022.2072977","article-title":"Effects of sulfur dioxide, ozone, and ambient air pollution on lung histopathology, oxidative-stress biomarkers, and apoptosis-related gene expressions in rats","volume":"48","author":"Kheirouri","year":"2022","journal-title":"Exp. Lung Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"4203","DOI":"10.2147\/DDDT.S482309","article-title":"Ozone Administration Reduces Myocardial Ischemia Reperfusion Injury in Streptozotocin Induced Diabetes Mellitus Rat Model","volume":"18","author":"Dursun","year":"2024","journal-title":"Drug Des. Dev. Ther."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1111\/j.1745-7262.2007.00229.x","article-title":"Protective effects of vitamin E on ethane dimethane sulfonate-induced testicular toxicity in rats","volume":"9","author":"Sahinturk","year":"2007","journal-title":"Asian J. Androl."},{"key":"ref_50","unstructured":"(2022, April 16). Rat Sperm Morphological Assessment, Edition 1. Available online: http:\/\/www.irdg.co.uk\/Sperm_morphology.pdf."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1530\/jrf.0.0700219","article-title":"Development of an assay to assess the functional integrity of the human sperm membrane and its relationship to other semen characteristics","volume":"70","author":"Jeyendran","year":"1984","journal-title":"J. Reprod. Fertil."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1093\/humrep\/deg199","article-title":"Evaluation of the one-step eosin-nigrosin staining technique for human sperm vitality assessment","volume":"18","author":"Bjorndahl","year":"2003","journal-title":"Hum. Reprod."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Mortimer, D. (1994). Practical Laboratory Andrology, Oxford University Press.","DOI":"10.1093\/oso\/9780195065954.001.0001"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Ar\u0131can, E.Y., G\u00f6k\u00e7eo\u011flu Kayal\u0131, D., Ulus Karaca, B., Boran, T., \u00d6zt\u00fcrk, N., Okyar, A., Ercan, F., and \u00d6zhan, G. (2020). Reproductive effects of subchronic exposure to acetamiprid in male rats. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-65887-0"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/17\/8547\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:38:25Z","timestamp":1760035105000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/17\/8547"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,3]]},"references-count":54,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["ijms26178547"],"URL":"https:\/\/doi.org\/10.3390\/ijms26178547","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,3]]}}}