Agarwal Ashok, Allamaneni Shyam S R
Center for Advanced Research in Human Reproduction, Infertility and Sexual Function, Glickman Urological Institute , Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
J Indian Med Assoc. 2011 Mar;109(3):184-7.
Male factor accounts for almost 50% cases of infertility. The exact mechanism of sperm dysfunction is not known in many cases. Extensive research in the last decade has led to the identification of free radicals (reactive oxygen species) as mediators of sperm dysfunction in both specific diagnoses and idiopathic cases of male infertility. Elevated levels of reactive oxygen species are seen in up to 30-80% of men with male infertility. The role of free radicals has been studied extensively in the process of human reproduction. We know now that a certain level of free radicals is necessary for normal sperm function, whereas an excessive level of free radicals can cause detrimental effect on sperm function and subsequent fertilisation and offspring health. Oxidative stress develops when there is an imbalance between generation of free radicals and scavenging capacity of anti-oxidants in reproductive tract. Oxidative stress has been shown to affect both standard semen parameters and fertilising capacity. In addition, high levels of free radicals have been associated with lack of or poor fertility outcome after natural conception or assisted reproduction. Diagnostic techniques to quantify free radicals in infertile patients can assist physicians treating patients with infertility to plan for proper treatment strategies. In vivo anti-oxidants can be used against oxidative stress in male reproductive tract. Supplementation of in vitro anti-oxidants can help prevent the oxidative stress during sperm preparation techniques in assisted reproduction.
男性因素导致了近50%的不孕病例。在许多情况下,精子功能障碍的确切机制尚不清楚。过去十年的广泛研究已确定自由基(活性氧)是男性不育特定诊断病例和特发性病例中精子功能障碍的介质。在高达30%-80%的男性不育患者中可观察到活性氧水平升高。自由基在人类生殖过程中的作用已得到广泛研究。我们现在知道,一定水平的自由基对于正常精子功能是必要的,而过量的自由基会对精子功能以及随后的受精和后代健康产生有害影响。当生殖道中自由基的产生与抗氧化剂的清除能力之间失衡时,就会产生氧化应激。氧化应激已被证明会影响标准精液参数和受精能力。此外,高水平的自由基与自然受孕或辅助生殖后生育能力缺乏或低下有关。量化不育患者体内自由基的诊断技术可以帮助治疗不育患者的医生制定适当的治疗策略。体内抗氧化剂可用于对抗男性生殖道中的氧化应激。体外补充抗氧化剂有助于在辅助生殖的精子制备技术过程中预防氧化应激。