Cellular and Molecular Life Sciences

, Volume 77, Issue 1, pp 93–113 | Cite as

Oxidative stress and male infertility: current knowledge of pathophysiology and role of antioxidant therapy in disease management

  • Erfaneh Barati
  • Hossein Nikzad
  • Mohammad KarimianEmail author


Infertility is a global health problem involving about 15% of couples. Approximately half of the infertility cases are related to male factors. The oxidative stress, which refers to an imbalance in levels of reactive oxygen species (ROS) and antioxidants, is one of the main causes of infertility in men. A small amount of ROS is necessary for the physiological function of sperm including the capacitation, hyperactivation and acrosomal reaction. However, high levels of ROS can cause infertility through not only by lipid peroxidation or DNA damage but inactivation of enzymes and oxidation of proteins in spermatozoa. Oxidative stress (OS) is mainly caused by factors associated with lifestyle. Besides, immature spermatozoa, inflammatory factors, genetic mutations and altering levels of sex hormones are other main source of ROS. Since OS occurs due to the lack of antioxidants and its side effects in semen, lifestyle changes and antioxidant regimens can be helpful therapeutic approaches to overcome this problem. The present study aimed to describe physiological ROS production, roles of genetic and epigenetic factors on the OS and male infertility with various mechanisms such as lipid peroxidation, DNA damage, and disorder of male hormone profile, inflammation, and varicocele. Finally, the roles of oral antioxidants and herbs were explained in coping with OS in male infertility.


Male infertility Oxidative stress Reactive oxygen species Genetic factors Antioxidants 











Androgen-binding protein


Antioxidant responsive element


Assisted reproductive techniques


Adenosine triphosphate


Base excision repair


Cyclic adenosine monophosphate




Creatine kinase


Cytochrome P450 enzymes


Electron transport chain


Glucose-6-phosphate dehydrogenase


Gonadotropin releasing hormone


Glutathione peroxidase






Glutathione s-transferase


Hydrogen peroxide










Lipid hydroperoxides




Micro-ribonucleic acids






Adenine dinucleotide phosphate


Nitrogen oxide


Nitric oxide synthase


Nuclear factor erythroid 2-related factor 2


Superoxide anion




Oxidative stress




Prostaglandin E2


Protein kinase A


Nucleotide excision repair








Polyunsaturated fatty acids


Radio frequency




Reactive oxygen species


Spinal cord injury


Sperm DNA fragmentation


Sulfhydryl groups


Superoxide dismutase


Extracellular SOD


Total antioxidant capacity


Tumor necrosis factor alpha





This work was supported by grants from the Vice Chancellor for Research and Technology, Kashan University of Medical Sciences, Kashan, Iran.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Anatomical Sciences Research CenterKashan University of Medical SciencesKashanIran
  2. 2.Gametogenesis Research CenterKashan University of Medical SciencesKashanIran

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