Ashok Agarwal

Methods for the Detection of ROS in Human Sperm Samples

Male-factor significantly contributes to infertility in couples of reproductive age. Several studies have shown that oxidative stress (OS) is involved in the pathophysiology of male infertility. It is caused by an imbalance between the formation of reactive oxygen species (ROS) and the ability of the antioxidants to scavenge them. There are several methods to measure seminal ROS in the clinical setting, most notably among them is the chemiluminescence assay. This technique measures the global ROS, i.e., both the intra- and extracellular ROS. The measurement of seminal ROS employing the chemiluminescence technique in clinical andrology labs is explained in this chapter. Through a deeper understanding of ROS and its measurement, clinical andrology labs can better assist patients to achieve increased rates of fertility and pregnancy.

Clinical Consequences of Oxidative Stress in Male Infertility

Male infertility affects 40% of infertile couples in the USA and may be attributed to conditions such as varicocele, leukocytospermia, infection, and idiopathic infertility. Such conditions may be associated with elevated levels of reactive oxygen species (ROS), decreased antioxidants, and oxidative stress (OS). OS can lead to male infertility in both an in vitro and in vivo setting. The negative effects of ROS on male fertility present as sperm DNA damage, decreasing motility, apoptosis, and lipid peroxidation. ROS and antioxidant levels can be measured and quantified in order to detect OS in semen samples. Both oral antioxidant therapy and culture media supplementation have proven to be effective in reducing OS. Future research is still needed in order to better understand the mechanisms involved in oxidative damage in the context of male infertility and to improve the treatments available for patients with OS-mediated male factor infertility.

The Role of Obesity in ROS Generation and Male Infertility

Aim: To discuss the relationship between obesity and male infertility, specifically exploring the role of reactive oxygen species (ROS) production in obesity and the subsequent generation of oxidative stress, as well as abnormal hypothalamus-xadpituitary-gonadal regulation associated with obese males. Methods: Review of PubMed database. Results: Both enhanced ROS generation and abnormal hormonal regulation due to obesity are strongly correlated to suboptimal semen quality and, thus, reduced male reproductive potential. Conclusion: The continuing rise and prevalence of both obesity and declining male sperm count all over the world call for additional research and a greater awareness to obesity as a potential etiology of male infertility.

Oxidative Stress and the Use of Antioxidants for Idiopathic OATs

Aim: To examine the effects of ROS and OS on male fertility and to evaluate the use of antioxidants as a means of treatment to improve fertilization rates in subfertile males suffering from idiopathic oligoasthenoteratozoospermia (iOAT). Methods: Review of PubMed database. Results: Current research notes ROS-associated male factor infertility to be the most common potential etiology of impaired sperm quality. The various effects of these oxidants may be neutralized by antioxidants. Although antioxidant therapy has shown to potentially treat iOAT by improving semen parameters, its success remains limited. Our review calls for a deeper look and understanding of the type(s), dosage, and duration of antioxidant treatment used in order to apply its use in a clinical setting.

Leukocytospermia and Oxidative Stress

The invasion of microorganisms and infective bacteria in the genito-xadurinary tract leads to the rapid increase in white blood cells, a condition referred to as leukocytospermia. This inflammatory response, aimed at killing the microorganisms via the production and release of reactive oxygen species (ROS), can result in pathologically high concentrations of ROS. When these concentrations greatly exceed the level required for normal physiological function, the natural defense system of scavenging antioxidants can be overwhelmed, resulting in oxidative stress (OS) thereby compromising the integrity of spermatozoa and functional parameters vital for successful fertilization. The complexity of OS is furthered when additional factors (e.g., smoking, varicocele) increase ROS levels in the male genito-urinary system. At present, the association between semen parameters and leukocyte concentrations is a focal point in the field of male reproductive science. This chapter aims at exploring the relationship between leukocytospermia, OS, the harmful effects on male reproductive potential, as well as possible treatment regimes.