{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T23:17:22Z","timestamp":1788391042614,"version":"build-2803163510"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n                    Oxidative stress is one of the main mechanisms responsible for male infertility. Various conditions such as varicocele, obesity, advanced age, and lifestyle can lead to an increase in reactive oxygen species, causing an oxidative imbalance in the reproductive environment. Spermatozoa are sensitive to reactive oxygen species and require energy to carry out their main function of fertilizing the egg. Excessive reactive oxygen species can affect sperm metabolism, leading to immobility, impaired acrosome reaction, and cell death, thereby impairing reproductive success. This double-blind randomized study evaluated the effect of supplementation with L-carnitine, acetyl-L-carnitine, vitamins, and other nutrients on semen quality in 104 infertile patients with or without varicocele, while also investigating the impact of factors such as obesity and advanced age on treatment. Sperm concentration significantly increased in the supplemented group compared to the placebo group (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.0186). Total sperm count also significantly increased in the supplemented group (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.0117), as did sperm motility (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.0120). The treatment had a positive effect on patients up to 35 years of age in terms of sperm concentration (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.0352), while a body mass index (BMI) above 25 kg m\n                    <jats:sup>\u22122<\/jats:sup>\n                    had a negative effect on sperm concentration (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.0110). Results were not showing a net benefit in stratifying patients in accordance with their BMI since sperm quality increase was not affected by this parameter. In conclusion, antioxidant supplementation may be beneficial for infertile patients and has a more positive effect on younger patients with a normal weight.\n                  <\/jats:p>","DOI":"10.4103\/aja202381","type":"journal-article","created":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T14:17:19Z","timestamp":1706797039000},"page":"239-244","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Antioxidant treatment for oligoasthenoteratozoospermia and varicocele: a DBPC trial to evaluate the impact of age and body mass index"],"prefix":"10.4103","volume":"26","author":[{"given":"Gian Maria","family":"Busetto","sequence":"first","affiliation":[{"name":"University of Foggia, Foggia 71122, Italy"},{"name":"Department of Urology and Renal Transplantation, Policlinico of Foggia, Foggia 71122, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernarde F","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Department of Urology, Human Reproduction Section, Federal University of Sao Paulo, Sao Paulo 05403-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraf","family":"Virmani","sequence":"additional","affiliation":[{"name":"Alfasigma Healthscience, Utrecht 3528 BG, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Checchia","sequence":"additional","affiliation":[{"name":"University of Foggia, Foggia 71122, Italy"},{"name":"Urology Unit, \u201cG. Tatarella\u201d Hospital, Cerignola 71042, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Ninivaggi","sequence":"additional","affiliation":[{"name":"University of Foggia, Foggia 71122, Italy"},{"name":"Department of Urology and Renal Transplantation, Policlinico of Foggia, Foggia 71122, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Ricapito","sequence":"additional","affiliation":[{"name":"University of Foggia, Foggia 71122, Italy"},{"name":"Department of Urology and Renal Transplantation, Policlinico of Foggia, Foggia 71122, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Barbieri","sequence":"additional","affiliation":[{"name":"University of Foggia, Foggia 71122, Italy"},{"name":"Department of Urology and Renal Transplantation, Policlinico of Foggia, Foggia 71122, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piero","family":"Fischetti","sequence":"additional","affiliation":[{"name":"University of Foggia, Foggia 71122, Italy"},{"name":"Department of Urology and Renal Transplantation, Policlinico of Foggia, Foggia 71122, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ugo G","family":"Falagario","sequence":"additional","affiliation":[{"name":"University of Foggia, Foggia 71122, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Annese","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplantation, Policlinico of Foggia, Foggia 71122, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"d\u2019Altilia","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplantation, Policlinico of Foggia, Foggia 71122, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"Mancini","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplantation, Policlinico of Foggia, Foggia 71122, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Ferro","sequence":"additional","affiliation":[{"name":"Urology Unit, European Institute of Oncology (IEO) IRCCS, Milan 20142, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felice","family":"Crocetto","sequence":"additional","affiliation":[{"name":"University of Naples Federico II, Naples 80126, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Porreca","sequence":"additional","affiliation":[{"name":"Department of Oncological Urology, Veneto Institute of Oncology (IOV) IRCCS, Padua 35039, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Bettocchi","sequence":"additional","affiliation":[{"name":"University of Foggia, Foggia 71122, Italy"},{"name":"Department of Urology and Renal Transplantation, Policlinico of Foggia, Foggia 71122, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Cormio","sequence":"additional","affiliation":[{"name":"University of Foggia, Foggia 71122, Italy"},{"name":"Urology Unit, \u201cL. 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