Territorial Center of Andrology, AUSL 8, Syracuse, Italy.
Reprod Biomed Online. 2009 Nov;19(5):638-59. doi: 10.1016/j.rbmo.2009.09.014.
Oxidative stress (OS) has been recognized as one of the most important cause of male infertility. Despite the antioxidant activity of seminal plasma, epididymis and spermatozoa, OS damages sperm function and DNA integrity. Since antioxidants suppress the action of reactive oxygen species, these compounds have been used in the medical treatment of male infertility or have been added to the culture medium during sperm separation techniques. Nevertheless, the efficacy of such a treatment has been reported to be very limited. This may relate to: (i) patient selection bias; (ii) late diagnosis of male infertility; (iii) lack of double-blind, placebo-controlled clinical trial; and/or (iv) use of end-points that are not good markers of the presence of OS. This review considers the effects of the main antioxidant compounds used in clinical practice. Overall, the data published suggest that no single antioxidant is able to enhance fertilizing capability in infertile men, whereas a combination of them seems to provide a better approach. Taking into account the pros and the cons of antioxidant treatment of male infertility, the potential advantages that it offers cannot be ignored. Therefore, antioxidant therapy should remain in the forefront of preventive medicine, including human reproductive medicine.
氧化应激（OS）已被认为是男性不育的最重要原因之一。尽管精液、附睾和精子都具有抗氧化活性，但 OS 仍会损害精子功能和 DNA 完整性。由于抗氧化剂可以抑制活性氧的作用，因此这些化合物已被用于男性不育的医学治疗中，或者被添加到精子分离技术的培养基中。然而，这种治疗的效果非常有限。这可能与以下几个因素有关：（i）患者选择偏倚；（ii）男性不育的诊断较晚；（iii）缺乏双盲、安慰剂对照的临床试验；和/或（iv）使用的终点不是 OS 存在的良好标志物。本文综述了临床实践中使用的主要抗氧化化合物的作用。总体而言，已发表的数据表明，没有单一的抗氧化剂能够提高不育男性的受精能力，而联合使用它们似乎提供了更好的方法。考虑到男性不育抗氧化治疗的利弊，它提供的潜在优势不容忽视。因此，抗氧化治疗应在预防医学，包括人类生殖医学中处于领先地位。
