Agarwal Ashok, Majzoub Ahmad
American Center for Reproductive Medicine and the Department of Urology, Cleveland Clinic, Cleveland, OH, USA.
Department of Urology, Hamad Medical Hospital, Doha, Qatar.
World J Mens Health. 2017 Aug;35(2):77-93. doi: 10.5534/wjmh.2017.35.2.77. Epub 2017 Apr 30.
Oxidative stress (OS) has been recognized as a significant cause of suboptimal assisted reproductive outcome. Many of the sperm preparation and manipulation procedures that are necessary in the in vitro environment can result in excessive production of reactive oxygen species (ROS) thereby exposing the gametes and growing embryos to significant oxidative damage. Antioxidants have long been utilized in the management of male subfertility as they can counterbalance the elevated levels of ROS inducing a high state of OS. Few studies have looked into the clinical effectiveness of antioxidants in patients undergoing assisted reproduction. While an overall favorable outcome has been perceived, the specific clinical indication and optimal antioxidant regimen remain unknown. The goal of our review is to explore the sources of ROS in the in vitro environment and provide a clinical scenario-based approach to identify the circumstances where antioxidant supplementation is most beneficial to enhance the outcome of assisted reproduction.
氧化应激(OS)已被公认为辅助生殖效果欠佳的一个重要原因。体外环境中许多必要的精子制备和操作程序会导致活性氧(ROS)过度产生,从而使配子和发育中的胚胎受到显著的氧化损伤。长期以来,抗氧化剂一直被用于治疗男性生育力低下,因为它们可以抵消升高的ROS水平,从而引发高度的氧化应激状态。很少有研究探讨抗氧化剂在接受辅助生殖的患者中的临床疗效。虽然总体上已观察到良好的结果,但具体的临床适应症和最佳抗氧化剂方案仍不清楚。我们综述的目的是探讨体外环境中ROS的来源,并提供一种基于临床情况的方法,以确定补充抗氧化剂最有利于提高辅助生殖效果的情况。