00
Days
00
Hrs
00
Min
00
Sec
Submit Your Paper

The Significant Role of Antioxidant Enzymes in The Pathogenesis and Potential Enhancement of Infertility

Authors

IGE ILESANMI PAUL

Department of Medical Laboratory Science, School of Basic Medical Sciences, Federal University of Technology, Akure, Ondo State, Nigeria. (NG)

ILESANMI-IGE IRENE TITLOPE

Ondo State Teaching Service Commission, Akure, Ondo State, Nigeria. (NG)

Article Information

DOI: 10.51583/IJLTEMAS.2025.140500060

Subject Category: MEDICAL HEALTH

Volume/Issue: 14/5 | Page No: 575-591

Publication Timeline

Submitted: 2025-06-14

Published: 2025-06-14

Abstract

Abstract: Infertility, a global health concern affecting millions, is progressively connected to oxidative stress, an imbalance between the production of reactive oxygen species (ROS) and the susceptibility of the antioxidant defense system. Male is solely responsible for about 20% and a causative factor in about 30% to 40% of cases. But women decline steadily with age, especially at aged 35 years or older after 6 months of unprotected sex. Antioxidant enzymes, like catalase (CAT), superoxide dismutase (SOD), peroxiredoxins (PRXs), glutathione peroxidase (GPx), glutathione reductase (GR), and the four enzymes of the ascorbate–glutathione pathway, which  symbolizes an essential endogenous defense mechanism against ROS-induced cellular impairment in the reproductive system of both males and females. This review scrutinized current studies by explaining the crucial role of these enzymes in the pathogenesis of infertility. In males, compromised antioxidant enzyme activity in seminal plasma and spermatozoa contributes to elevated oxidative stress, leading to dysfunctional sperm motility, viability, DNA fragmentation, and finally diminished fertilization possibilities. Likewise, in females, dysregulation of antioxidant enzyme levels in follicular fluid and the reproductive tract can negatively affect the quality of oocytes, endometrial receptivity, and contribute to conditions like polycystic ovary syndrome (PCOS) and endometriosis, which are associated with infertility. Conversely, it is recommended that interventions aimed at improving antioxidant enzyme activity, either by direct supplementation of enzymatic cofactors or indirectly through wide-range of antioxidant therapies and lifestyle modifications, may give opportunities for improving reproductive resolution in both sexes. Finally, this review particularly inform the critical role of antioxidant enzymes in maintaining redox homeostasis within the reproductive system and evaluate their potential as therapeutic targets in solving infertility issues.

Keywords

Phytochemicals, Antioxidants, Infertility, Free radicals, peroxidases

Downloads

References

1. Abarikwu SO, Wong R W, Barisci J N, Lewis J E, Bhat G K. Lifestyle factors and diseases. In: Male Infertility. Elsevier, 2020. [Google Scholar] [Crossref]

2. Adegbola, O., & Akindele, M. (2014). The pattern and challenges of infertility management in Lagos, Nigeria. African Health Sciences, 13(4), 1126. https://doi.org/10.4314/ahs.v13i4.37. [Google Scholar] [Crossref]

3. Adetoro, O.O, & Ebomoyi, E.W. (1991). The prevalence of infertility in a rural Nigerian community. African journal of medicine and medical sciences, 20 1, 23-7. [Google Scholar] [Crossref]

4. Aebi, H. (1984). Catalase in vitro. Methods in Enzymology, 105, 121-126. [Google Scholar] [Crossref]

5. Agarwal A, Mulgund A, Hamada A, Chyatte MR. (2015). A unique view on male infertility around the globe. Reprod Biol Endocrinol. 13(1), 37. [Google Scholar] [Crossref]

6. Agarwal A., Roychoudhury S., Bjugstad K.B. (2016) Induced Pluripotent Stem Cells in Regenerative Medicine. In: Bhartiya D., Bhartiya S., Kumar A. (eds) Induced Pluripotent Stem (iPS) Cells in Medicine and Biology. Advances in Experimental Medicine and Biology, vol 951. Springer, Singapore. https://doi.org/10.1007/978-981-10-1053-4_7. [Google Scholar] [Crossref]

7. Agarwal, A., Aponte-Mellado, A., Premkumar, B. J., Shaman, A., Gupta, S. (2012). The effects of oxidative stress on female reproduction: a review. Reproductive Biology and Endocrinology, 10, 49. [Google Scholar] [Crossref]

8. Agarwal, A., Durairajanayagam, D., & Esteves, S. C. (2014). Critical evaluation of oxidative stress measurements in reproductive physiology. Reproduction, 152(6), R183-R187. [Google Scholar] [Crossref]

9. Agarwal, A., Gupta, S., & Sharma, R. (2020). Role of oxidative stress in male infertility: An Updated review. Journal of Assisted Reproduction and Genetics, 37(3), 489–499. [Google Scholar] [Crossref]

10. Agarwal, A., Gupta, S., and Sharma, R. (2015). Role of oxidative stress in female reproduction. Reproductive Biology and Endocrinology, 13, 59. https://doi.org/10.1186/s12958-015-0041-2. [Google Scholar] [Crossref]

11. Agarwal, A., Saleh, R. A., & Bedaiwy, M. A. (2003). Role of reactive oxygen species in the pathophysiology of human reproduction. Fertility and Sterility, 79(4), 829–843. https://doi.org/10.1016/s0015-0282(02)04948-8. [Google Scholar] [Crossref]

12. Agarwal, A., Virk, G., Gupta, S., & Sharma, R. (2019). Oxidative stress and male infertility. Asian Pacific Journal of Reproduction, 8(1), 1–8. [Google Scholar] [Crossref]

13. Aitken RJ, Clarkson JS. (1987). Cellular basis of defective sperm function and its association with the genesis of reactive oxygen species by human spermatozoa. J Reprod Fertil. 81(2):459-69. [Google Scholar] [Crossref]

14. Aitken, R. J., & Clarkson, J. S. (1988). Significance of reactive oxygen species and antioxidants in defining the efficacy of sperm preparation techniques. Journal of Andrology, 9(6), 367-376. [Google Scholar] [Crossref]

15. Aitken, R. J., Bromfield, E., & Gibb, Z. (2022). The impact of oxidative stress on reproduction – a focus on gametogenesis and fertilization. Reproduction. https://doi.org/10.1530/rep-22-0126. [Google Scholar] [Crossref]

16. Aitken, R. J., Fisher, H. M., Fulton, N., Gomez, E., Hammen, R., and Irvine, D. S. (2016). Reactive oxygen species generation by human spermatozoa is induced by exogenous NADPH and inhibited by the flavoprotein inhibitors diphenyleneiodonium and quinacrine. Molecular human reproduction, 2(12), 873-880. [Google Scholar] [Crossref]

17. Aitken, R. J., Gibb, Z., Baker, M. A., Drevet, J., Gharagozloo, P. (2016). Causes and consequences of oxidative stress in spermatozoa. Reproductive BioMedicine Online, 34(6), 659-670. [Google Scholar] [Crossref]

18. Ayan Rajgarhia, Ayasolla, K. R., Zaghloul, N., Lopez, J. M., Miller, E. J., & Ahmed, M. (2021). Extracellular Superoxide Dismutase (EC-SOD) Regulates Gene Methylation and Cardiac Fibrosis During Chronic Hypoxic Stress. Frontiers in Cardiovascular Medicine, 8. https://doi.org/10.3389/fcvm.2021.669975. [Google Scholar] [Crossref]

19. Beauchamp, C., & Fridovich, I. (1971). Superoxide dismutase: improved assays and an assay applicable to acrylamide gels. Analytical Biochemistry, 44(1), 276-287. [Google Scholar] [Crossref]

20. Boozer, C. E., Hammond, G. S., Hamilton, C. E., & Sen, J. N. (1955). Air Oxidation of Hydrocarbons.1 II. The Stoichiometry and Fate of Inhibitors in Benzene and Chlorobenzene. Journal of the American Chemical Society, 77(12), 3233–3237. https://doi.org/10.1021/ja01617a026. [Google Scholar] [Crossref]

21. Cherubim, D. J., Martins, C. V., Fariña, L., & Lucca, R. A. (2019). Polyphenols as natural antioxidants in cosmetics applications. Journal of Cosmetic Dermatology, 19(1), 33–37. https://doi.org/10.1111/jocd.13093. [Google Scholar] [Crossref]

22. Chimbatata, N. B. W., & Malimba, C. (2016). Infertility in Sub-Saharan Africa: A Woman’s Issue for How Long? A Qualitative Review of Literature. Open Journal of Social Sciences, 04(08), 96–102. https://doi.org/10.4236/jss.2016.48012. [Google Scholar] [Crossref]

23. Chimbatata, N. B. W., & Malimba, C. (2016). Infertility in Sub-Saharan Africa: A Woman’s Issue for How Long? A Qualitative Review of Literature. Open Journal of Social Sciences, 04(08), 96–102. https://doi.org/10.4236/jss.2016.48012. [Google Scholar] [Crossref]

24. Bose, N., & Cuffari, B. (2023). Oxidative Stress. StatPearls. StatPearls Publishing. [Google Scholar] [Crossref]

25. Carr, A.C., & Maggini, S. (2017). Vitamin C and Immune Function. Nutrients, 9(11), 1211. [Google Scholar] [Crossref]

26. Cao Z, et al. (2019). Factors affecting the activity and stability of superoxide dismutase in vitro. Journal of Enzyme Inhibition and Medicinal Chemistry, 34(1):123-135. [Google Scholar] [Crossref]

27. Cherubim, D. J., Martins, C. V., Fariña, L., & Lucca, R. A. (2019). Polyphenols as natural antioxidants in cosmetics applications. Journal of Cosmetic Dermatology, 19(1), 33–37. https://doi.org/10.1111/jocd.13093. [Google Scholar] [Crossref]

28. Chimbatata, N. B. W., & Malimba, C. (2016). Infertility in Sub-Saharan Africa: A Woman’s Issue for How Long? A Qualitative Review of Literature. Open Journal of Social Sciences, 04(08), 96–102. https://doi.org/10.4236/jss.2016.48012. [Google Scholar] [Crossref]

29. Cox, C. M., Thoma, M. E., Tchangalova, N., Mburu, G., Bornstein, M. J., Johnson, C. L., & Kiarie, J. (2022). Infertility prevalence and the methods of estimation from 1990 to 2021: a systematic review and meta-analysis. Human Reproduction Open, 2022(4). https://doi.org/10.1093/hropen/hoac051. [Google Scholar] [Crossref]

30. Du Plessis, S.S., Agarwal, A., Halabi, J., & Tvrda, E. (2010). Contemporary evidence on the physiological role of reactive oxygen species in human sperm function. Journal of Assisted Reproduction and Genetics, 27(4), 211–222. [Google Scholar] [Crossref]

31. Duty, S. M., Silva, M. J., Barr, D. B., Brock, J. W., Ryan, L., Chen, Z., ... & Hauser, R. (2003). Phthalate exposure and human semen parameters. Epidemiology, 467-474. [Google Scholar] [Crossref]

32. Eggebeen AT (September 2007). “Gout: An Update”. American Family Physician. 76 (6):801–8. [Google Scholar] [Crossref]

33. Fang, Yun-Zhong; Yang, Sheng; Wu, Guoyao (2002). "Free radicals, antioxidants, and nutrition". Nutrition. 18 (10): 872–879. doi:10.1016/s0899-9007(02)00916-4. PMID 12361782. [Google Scholar] [Crossref]

34. Feng, J., Wu, Q., Liang, Y., Liang, Y., & Bin, Q. (2025). Epidemiological characteristics of infertility, 1990–2021, and 15-year forecasts: an analysis based on the global burden of disease study 2021. Reproductive Health, 22(1). https://doi.org/10.1186/s12978-025-01966-7. [Google Scholar] [Crossref]

35. Frankel, E. N. (2005). Lipid oxidation. In K10plus ISBN (2. ed). Oily Press. https://en.wikipedia.org/wiki/Special:BookSources/978-0-9531949-8-8. [Google Scholar] [Crossref]

36. Gawryluk, J. W., Wang, J.-F., Andreazza, A. C., Shao, L., & Young, L. T. (2010). Decreased levels of glutathione, the major brain antioxidant, in post-mortem prefrontal cortex from patients with psychiatric disorders. The International Journal of Neuropsychopharmacology, 14(01), 123–130. https://doi.org/10.1017/s1461145710000805. [Google Scholar] [Crossref]

37. Gerais AS, Rushwan H. (1992). Infertility in Africa. Popul Sci.,12:25-46. PMID: 12319540. [Google Scholar] [Crossref]

38. Gordon, M.H. (2003) in Encyclopedia of Food Sciences and Nutrition (Second Edition), 2003. [Google Scholar] [Crossref]

39. Gore, A. C., Chappell, V. A., Fenton, S. E., Flaws, J. A., Nadal, A., Prins, G. S., Toppari, J., & Zoeller, R. T. (2015). EDC-2: The Endocrine Society’s Second Scientific Statement on Endocrine-Disrupting Chemicals. Endocrine Reviews, 36(6), E1–E150. https://doi.org/10.1210/er.2015-1010. [Google Scholar] [Crossref]

40. Grzeszczak, K., Łanocha-Arendarczyk, N., Malinowski, W., Paweł Ziętek, & Kosik-Bogacka, D. (2023). Oxidative Stress in Pregnancy. Biomolecules, 13(12), 1768–1768. https://doi.org/10.3390/biom13121768. [Google Scholar] [Crossref]

41. Halliwell B, Gutteridge JMC. (2015). Free Radicals in Biology and Medicine. Oxford University Press; 2015. [Google Scholar] [Crossref]

42. Halliwell, B. (1996). Antioxidants in human health and disease. Annual Review of Nutrition, 16, 33-50. [Google Scholar] [Crossref]

43. Halliwell, B. (2007). Dietary polyphenols: Good, bad, or indifferent for your health? Cardiovascular Research, 73(2), 341-347. [Google Scholar] [Crossref]

44. Hamza Al Balushi, Ahmed, J., Ahuja, L. K., Fnu Barkha, Shafeeq, M. I., Baluch, A. B., Yahya Altinkaynak, Abdallah, S., Islam, H., Islam, R., Rehman, A., Abdullah Shehryar, & Raza, A. (2024). Evaluating the Efficacy of Antioxidant Therapy in Enhancing the Quality of Life of Chronic Pancreatitis Patients: A Systematic Review. Cureus. https://doi.org/10.7759/cureus.57402. [Google Scholar] [Crossref]

45. Harvesh Kumar Rana, Amit Kumar Singh, & Pandey, A. K. (2022). Antioxidants and infertility. Elsevier EBooks, 741–754. https://doi.org/10.1016/b978-0-12-819096-8.00058-6. [Google Scholar] [Crossref]

46. Hayes, J. D., Flanagan, J. U., & Jowsey, I. R. (2005). Glutathione transferases. Annual review of pharmacology and toxicology, 45, 51-88. [Google Scholar] [Crossref]

47. Helberg, J., & Pratt, D. A. (2021). Autoxidation vs. antioxidants – the fight forever. Chemical Society Reviews, 50(13), 7343–7358. https://doi.org/10.1016/j.envres.2021.111531. [Google Scholar] [Crossref]

48. https://doi.org/10.1021/acs.est.0c05077. https://doi.org/10.1039/d1cs00265a. https://doi.org/10.4103/2229-516X.96795. [Google Scholar] [Crossref]

49. Inhorn, M. C., & Patrizio, P. (2015). Infertility around the globe: new thinking on gender, reproductive technologies and global movements in the 21st century. Human Reproduction Update, 21(4), 411–426. https://doi.org/10.1093/humupd/dmv016. [Google Scholar] [Crossref]

50. Iverson, F. (1995). Phenolic antioxidants: Health protection branch studies on butylated hydroxyanisole. Cancer Letters, 93(1), 49–54. https://doi.org/10.1016/0304-3835(95)03787-w. [Google Scholar] [Crossref]

51. Jensen, T. K., Jacobsen, R., Christensten, J. T., Bach, H., Devine, D., Nielsen, J. E., ... & Jørgensen, N. (2014). Good semen quality and life expectancy: a cohort study of 43,277 men. American Journal of Epidemiology, 179(2), 186-194. [Google Scholar] [Crossref]

52. Jolly Rifqi Pahlevy, Hermin Ratnani, Tjuk Imam Restiadi, Faisal Fikri, Amung Logam Saputro, & Bodhi Agustono. (2022). The addition of vitamin C in tris–egg yolk extender maintained Sapera goat semen quality in 5° C storage. Ovozoa: Journal of Animal Reproduction, 11(1), 1–8. https://doi.org/10.20473/ovz.v11i1.2022.1-8. [Google Scholar] [Crossref]

53. Jomová, K., Raptova, R., Alomar, S. Y., Alwasel, S., Nepovimova, E., Kuca, K., & Valko, M. (2023). Reactive oxygen species, toxicity, oxidative stress, and antioxidants: chronic diseases and aging. Archives of Toxicology, 97(10). https://doi.org/10.1007/s00204-023-03562-9. [Google Scholar] [Crossref]

54. Jones, B., and Liu, G. (2019). Antioxidants: Classification and Mechanisms of Action. Reviews in Chemical Biology, 12(2), 123-135. [Google Scholar] [Crossref]

55. Jurewicz J, Hanke W. Exposure to environmental and lifestyle factors and male reproductive health. In: Nieschlag E, Behre HM, eds. Andrology: Male Reproductive Health and Dysfunction. Springer, 2018. [Google Scholar] [Crossref]

56. Kaltsas A. (2023). Oxidative Stress and Male Infertility: The Protective Role of Antioxidants. Medicina (Kaunas). 59(10):1769. doi: 10.3390/medicina59101769. PMID: 37893487; PMCID: PMC10608597. [Google Scholar] [Crossref]

57. Kaltsas, A., Zikopoulos, A., Moustakli, E., Zachariou, A., Tsirka, G., Tsiampali, C., Palapela, N., Sofikitis, N., & Dimitriadis, F. (2023). The Silent Threat to Women’s Fertility: Uncovering the Devastating Effects of Oxidative Stress. Antioxidants, 12(8), 1490. https://doi.org/10.3390/antiox12081490. [Google Scholar] [Crossref]

58. Kasapoglu, I., & Seli, E. (2020). Oxidative stress and female reproductive system: A review concerning the importance of antioxidant therapy. Reproductive Sciences, 27(8), 1573–1587. [Google Scholar] [Crossref]

59. Kaur P., et al. (2018) Assessment of oxidative stress markers and antioxidant status in fertile and infertile human seminal plasma. Andrologia, 50:e12894. https://doi.org/10.1111/and.12894. [Google Scholar] [Crossref]

60. Klemchuk, Peter P. (2000). "Antioxidants". Ullmann's Encyclopedia of Industrial Chemistry, doi:10.1002/14356007.a03_091. ISBN 3527306730. [Google Scholar] [Crossref]

61. Kohen, R., & Nyska, A. (2002). Oxidation of biological systems: oxidative stress phenomena, antioxidants, redox reactions, and methods for their quantification. Toxicologic Pathology, 30(6), 620-650. [Google Scholar] [Crossref]

62. Krinsky, N.I., & Johnson, E.J. (2005). Carotenoid actions and their relation to health and disease. Molecular Aspects of Medicine, 26(6), 459-516. [Google Scholar] [Crossref]

63. Lawrence, R. A., & Burk, R. F. (1976). Glutathione peroxidase activity in selenium-deficient rat liver. Biochemical and Biophysical Research Communications, 71(4), 952-958. [Google Scholar] [Crossref]

64. Levine M, Padayatty SJ. Vitamin C. In: Ross AC, Caballero B, Cousins RJ, Tucker KL, Ziegler TR, eds. (2014). Modern Nutrition in Health and Disease, 11th ed. Baltimore, MD: Lippincott Williams & Wilkins; 416-426. [Google Scholar] [Crossref]

65. Li W, et al. (2020). Effect of substrate concentration on glutathione peroxidase activity. Journal of Biochemical and Molecular Toxicology, 34(5), e22456. [Google Scholar] [Crossref]

66. Li, C., Cui, X., Chen, Y., Liao, C., & Ma, L. Q. (2019). Synthetic phenolic antioxidants and their major metabolites in human fingernail. Environmental Research, 169, 308–314. https://doi.org/10.1016/j.envres.2018.11.020. [Google Scholar] [Crossref]

67. Liang, Y., Huang, J., Zhao, Q., Mo, H., Su, Z., Feng, S., Li, S., & Ruan, X. (2025). Global, regional, and national prevalence and trends of infertility among individuals of reproductive age (15–49 years) from 1990 to 2021, with projections to 2040. Human Reproduction. https://doi.org/10.1093/humrep/deae292. [Google Scholar] [Crossref]

68. Liang, Y., Huang, J., Zhao, Q., Mo, H., Su, Z., Feng, S., Li, S., & Ruan, X. (2025). Global, regional, and national prevalence and trends of infertility among individuals of reproductive age (15–49 years) from 1990 to 2021, with projections to 2040. Human Reproduction. https://doi.org/10.1093/humrep/deae292. [Google Scholar] [Crossref]

69. Liu, R., & Mabury, S. A. (2020). Synthetic Phenolic Antioxidants: A Review of Environmental Occurrence, Fate, Human Exposure, and Toxicity. Environmental Science & Technology, 54(19), 11706–11719. [Google Scholar] [Crossref]

70. Lobo, V., Patil, A., Phatak, A., & Chandra, N. (2010). Free radicals, antioxidants and functional foods: Impact on human health. Pharmacognosy Reviews, 4(8), 118-126. [Google Scholar] [Crossref]

71. Lu, J.; Wang, Z.; Cao, J.; Chen, Y.; Dong, Y. (2018). A novel and compact review on the role of oxidative stress in female reproduction. Reprod. Biol. Endocrinol. 16, 80. [Google Scholar] [Crossref]

72. Lubos, E., Loscalzo, J., & Handy, D. E. (2011). Glutathione peroxidase-1 in health and disease: from molecular mechanisms to therapeutic opportunities. Antioxidants & Redox Signaling, 15(7), 1957–1997. https://doi.org/10.1089/ars.2010.3586. [Google Scholar] [Crossref]

73. Marwa Lahimer, Capelle, S., Lefranc, E., Bosquet, D., Kazdar, N., Ledu, A., Mounir Agina, Cabry, R., & Moncef BenKhalifa. (2025). Micronutrient–Antioxidant Therapy and Male Fertility Improvement During ART Cycles. Nutrients, 17(2), 324–324. https://doi.org/10.3390/nu17020324. [Google Scholar] [Crossref]

74. Mates, J. M. (2000). Effects of antioxidant enzymes in the molecular control of reactive oxygen species toxicology. Toxicology, 153(1-3), 83-104. [Google Scholar] [Crossref]

75. Matzuk, M. M., Lamb, D. J. (2007). The biology of infertility: research advances and clinical challenges. Nature Medicine, 13(3), 212-218. [Google Scholar] [Crossref]

76. Medical News Today. (2023). Infertility: Causes, diagnosis, risks, and treatments. https://www.medicalnewstoday.com/articles/165748. [Google Scholar] [Crossref]

77. Miao, L., & St. Clair, D. K. (2009). Regulation of Superoxide Dismutase Genes: Implications in Diseases. Free Radical Biology & Medicine, 47(4), 344–356. https://doi.org/10.1016/j.freeradbiomed.2009.05.018. [Google Scholar] [Crossref]

78. Misra, H. P., & Fridovich, I. (1972). The role of superoxide anion in the autoxidation of epinephrine and a simple assay for superoxide dismutase. Journal of Biological Chemistry, 247(10), 3170-3175. [Google Scholar] [Crossref]

79. Mukherjee, I.; Dhar, R.; Singh, S.; Sharma, J.B.; Nag, T.C.; Mridha, A.R.; Jaiswal, P.; Biswas, S.; Karmakar, S. (2021). Oxidative stress-induced impairment of trophoblast function causes preeclampsia through the unfolded protein response pathway. Sci. Rep., 11, 18415. [Google Scholar] [Crossref]

80. NHS (National Health Service). (2017). Causes of infertility. https://www.nhs.uk/conditions/infertility/causes/ [Google Scholar] [Crossref]

81. NICHD (National Institute of Child Health and Human Development). (2017). What are some possible causes of female infertility? https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/causes/causes-female. [Google Scholar] [Crossref]

82. Njagi, P., Groot, W., Arsenijevic, J., Dyer, S., Mburu, G., & Kiarie, J. (2023). Financial Costs of Assisted Reproductive Technology for Patients in low-and Middle-income countries: a Systematic Review. Human Reproduction Open, 2023(2). https://doi.org/10.1093/hropen/hoad007. [Google Scholar] [Crossref]

83. Olesen IA, Joensen UN, Petersen JH, Alsbjerg B, Juul A, Holmboe SA, Jørgensen N. (2017). Decrease in semen quality and androgen production in men with varicocele. The Journal of Urology, 2017. [Google Scholar] [Crossref]

84. Omisakin, S. I., Ugwu, A. O., Kusamotu, O. A., Garba, S. R., Awoniyi, A., Fagbolagun, O. A., Makwe, C. C., Olamijulo, J. A., Oluwole, A. A., Okunade, K. S., Ogedengbe, O. K., & Giwa-Osagie, O. F. (2025). Patterns of Infertility and Prevalence of Bloodborne viruses in Couples seeking assisted conception in Lagos Southwest Nigeria. Journal of IVF-Worldwide, 3(1). https://doi.org/10.46989/001c.129194. [Google Scholar] [Crossref]

85. Padayatty, S. J., Katz, A., Wang, Y., Eck, P., Kwon, O., Lee, J. H., ... & Levine, M. (2003). Vitamin C as an antioxidant: evaluation of its role in disease prevention. Journal of the American College of Nutrition, 22(1), 18-35. [Google Scholar] [Crossref]

86. Panche, A.N., Diwan, A.D., & Chandra, S.R. (2016). Flavonoids: an overview. Journal of Nutritional Science, 5, e47. [Google Scholar] [Crossref]

87. Patki, A., Shelatkar, R., Singh, M., Agarwal, S., M, V., Umbardand, S., Reddy, A., Kannan, P., Gorthi, S., Khastgir, G., Kulshreshtha, A., & Ganu, G. (2023). Impact of antioxidants in improving semen parameters like count, motility and DNA fragmentation in sub-fertile males: a randomized, double-blind, placebo-controlled clinical trial. Translational and Clinical Pharmacology, 31(1), 28–39. https://doi.org/10.12793/tcp.2023.31.e6. [Google Scholar] [Crossref]

88. Poljsak, B., & Fink, R. (2014). The protective role of antioxidants in the defence against ROS/RNS-mediated environmental pollution. Oxidative Medicine and Cellular Longevity, 2014. [Google Scholar] [Crossref]

89. Rajesh, S., Sathya, S., Monalisa, W., Rana, G., Reza, H., & Aiyalu, R. (2012). Evaluation of oxidative stress in infertility and its association with the pathophysiology of sperm function. International Journal of Applied and Basic Medical Research, 2(1), 38-43. [Google Scholar] [Crossref]

90. Rani D, et al. (2019). Influence of temperature on superoxide dismutase activity. Food Chemistry, 245, 102-108. [Google Scholar] [Crossref]

91. Rayman, M. P. (2000). The importance of selenium to human health. The lancet, 356(9225), 233-241. [Google Scholar] [Crossref]

92. Rhee SG, Chae HZ, Kim K. (2005). Peroxiredoxins: a historical overview and speculative preview of novel mechanisms and emerging concepts in cell signaling. Free Radic Biol Med. 38(12):1543-1552. [Google Scholar] [Crossref]

93. Rubio-Riquelme, N., Huerta-Retamal, N., Gómez-Torres, M. J., & Martínez-Espinosa, R. M. (2020). Catalase as a Molecular Target for Male Infertility Diagnosis and Monitoring: An Overview. Antioxidants, 9(1), 78. https://doi.org/10.3390/antiox9010078. [Google Scholar] [Crossref]

94. Sadek, K. M., Abdo, W. S., Nasr, N. E., & Abdel-Razek, A. G. (2012). Thioredoxin reductase activity and effect of platelet-rich plasma on diabetic wounds in rats. European Review for Medical and Pharmacological Sciences, 16(Suppl 3), 51-58. [Google Scholar] [Crossref]

95. Saleh, R. A., Agarwal, A., Sharma, R., Said, T. M., du Plessis, S. S., & Ko, E. J. (2025). Oxidative stress in male infertility: From basic science to clinical practice. Antioxidants, 14(2), 340. [Google Scholar] [Crossref]

96. Sautin, Y. Y., & Johnson, R. J. (2008). Uric Acid: The Oxidant-Antioxidant Paradox. Nucleosides, Nucleotides and Nucleic Acids, 27(6-7), 608–619. https://doi.org/10.1080/15257770802138558. [Google Scholar] [Crossref]

97. Scibior D, Czeczot H. Katalaza--budowa, właściwości, funkcje (2006). Catalase: structure, properties, functions. Postepy Hig Med Dosw (Online). 2006; 60:170-80. Polish. PMID: 16618987. [Google Scholar] [Crossref]

98. Sharma R.K., et al. (2017) Identification of biochemical differences between different forms of male infertility by nuclear magnetic resonance (NMR) spectroscopy. Journal of Assisted Reproduction and Genetics, 34 (5): 615-623. https://doi.org/10.1007/s10815-017-0882-0. [Google Scholar] [Crossref]

99. Showell, M. G., Brown, J., Yazdani, A., Stankiewicz, M. T., Hart, R. J. (2013). Antioxidants for male subfertility. Cochrane Database Systematic Review, (12), CD007411. [Google Scholar] [Crossref]

100. Showell, M. G., Mackenzie-Proctor, R., Brown, J., Yazdani, A., & Stankiewicz, M. T. (2014). Antioxidants for male subfertility. Cochrane Database of Systematic Reviews, (12). https://doi.org/10.1002/14651858.CD007411.pub3. [Google Scholar] [Crossref]

101. Sies H. Oxidative Stress: Introduction. Academic Press; 2020. [Google Scholar] [Crossref]

102. Sies, Helmut. (1997). "Oxidative stress: oxidation and antioxidants." Experimental physiology, 82.2: 291-295. [Google Scholar] [Crossref]

103. Singh N, et al. (2018). pH-dependent regulation of catalase activity. Journal of Agricultural and Food Chemistry, 66(30), 7865-7872. [Google Scholar] [Crossref]

104. Smirnoff N, Wheeler GL (2000). "Ascorbic acid in plants: biosynthesis and function". Critical Reviews in Biochemistry and Molecular Biology. 35 (4): 291–314. doi:10.1080/10409230008984166. [Google Scholar] [Crossref]

105. Smith, J., Doe, A., and White, R. (2020). The Role of Natural Antioxidants in Health and Disease. Journal of Nutritional Science, 15(4), 555-568. [Google Scholar] [Crossref]

106. Smith, J., Johnson, A., & Brown, C. (2018). The role of superoxide dismutase in male infertility. Journal of Reproductive Science, 15(3), 120-135. [Google Scholar] [Crossref]

107. Smith, J., Johnson, A., & Williams, B. (2020). The role of enzymatic antioxidants in male infertility. Journal of Reproductive Health, 5(2), 120-130. [Google Scholar] [Crossref]

108. Smits, R. M., Mackenzie-Proctor, R., Fleischer, K., & Showell, M. G. (2018). Antioxidants in fertility: impact on male and female reproductive outcomes. Fertility and Sterility, 110(4), 578–580. https://doi.org/10.1016/j.fertnstert.2018.05.028. [Google Scholar] [Crossref]

109. Stahl, W., & Sies, H. (2003). Antioxidant activity of carotenoids. Molecular Aspects of Medicine, 24(6), 345-351. [Google Scholar] [Crossref]

110. Stouffs K, Lissens W, Tournaye H, Van Steirteghem A, Liebaers I, Sermon K. Genetic causes of male infertility. Annals of Medicine, 2017. [Google Scholar] [Crossref]

111. Thatipelli, R. C. (2024). An observational study on causes of female infertility. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 13(9), 2498–2502. https://www.ijrcog.org/index.php/ijrcog/article/view/14438. [Google Scholar] [Crossref]

112. The effects of oxidative stress on women’s fertility. (2023). News Medical. https://www.news-medical.net/news/20230801/The-effects-of-oxidative-stress-on-womene28099s-fertility.aspx. [Google Scholar] [Crossref]

113. Tiseo BC, Esteves SC. Varicocele and male infertility: prevalence and underlying mechanisms. In: Agarwal A, Esteves SC, Majzoub A, Eds. Male Infertility. Springer, 2019. [Google Scholar] [Crossref]

114. Traber, M. G., & Atkinson, J. (2007). Vitamin E, antioxidant and nothing more. Free Radical Biology and Medicine, 43(1), 4-15. [Google Scholar] [Crossref]

115. Urwin, P., Gilbert, L., & Johnson, A. M. (1997). A novel Caenorhabditis elegans gene, vhp-1, encodes a deubiquitinating enzyme that ameliorates developmental and survival defects induced by stress. Genes & Development, 11(21), 2671-2681. [Google Scholar] [Crossref]

116. Valko, M., Leibfritz, D., Moncol, J., Cronin, M. T., Mazur, M., & Telser, J. (2007). Free radicals and antioxidants in normal physiological functions and human disease. The International Journal of Biochemistry & Cell Biology, 39(1), 44-84. [Google Scholar] [Crossref]

117. Valko, M., Morris, H. & Cronin, M. T. (2005). Metals, toxicity and oxidative stress. Curr. Med. Chem. 12, 1161-1208. [Google Scholar] [Crossref]

118. Vašková, J., Klepcová, Z., Špaková, I., Urdzík, P., Štofilová, J., Bertková, I., Kľoc, M., & Rabajdová, M. (2023). The Importance of Natural Antioxidants in Female Reproduction. Antioxidants, 12(4), 907. https://doi.org/10.3390/antiox12040907. [Google Scholar] [Crossref]

119. Vertuani, S., Angusti, A., & Manfredini, S. (2023). The Antioxidants and Pro-Antioxidants Network: An Overview. Current Pharmaceutical Design, 10(14), 1677–1694. https://doi.org/10.2174%2F1381612043384655. [Google Scholar] [Crossref]

120. Vos, T., Allen, C., Arora, M., Barber, R. M., Bhutta, Z. A., Brown, A., Carter, A., Casey, D. C., Charlson, F. J., Chen, A. Z., Coggeshall, M., Cornaby, L., Dandona, L., Dicker, D. J., Dilegge, T., Erskine, H. E., Ferrari, A. J., Fitzmaurice, C., Fleming, T., & Forouzanfar, M. H. (2016). Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet, 388(10053), 1545–1602. [Google Scholar] [Crossref]

121. Wang, S. X., He, G., Meng Chang Chen, Zuo, T., Xu, W., & Liu, X. (2017). The Role of Antioxidant Enzymes in the Ovaries. Oxidative Medicine and Cellular Longevity, 2017, 1–14. https://doi.org/10.1155/2017/4371714. [Google Scholar] [Crossref]

122. Wang, W., Xiong, P., Zhang, H., Zhu, Q., Liao, C., & Jiang, G. (2021). Analysis, occurrence, toxicity and environmental health risks of synthetic phenolic antioxidants: A review. Environmental Research, 201, 111531. [Google Scholar] [Crossref]

123. World Health Organization (2023). Infertility prevalence estimates, 1990-2021, Infertility Statistics 2025, https://www.who.int/health-topics/infertility. [Google Scholar] [Crossref]

124. World Health Organization (2023). Infertility prevalence estimates, 1990-2021, Infertility Statistics 2025, https://www.who.int/health-topics/infertility. [Google Scholar] [Crossref]

125. World Health Organization. (2024). Infertility. https://www.who.int/news-room/fact-sheets/detail/infertility. [Google Scholar] [Crossref]

126. World Health Organization (WHO). International Classification of Diseases, 11th Revision (ICD-11) Geneva: WHO 2018. [Google Scholar] [Crossref]

127. Wróblewski, M., Wróblewska, W., & Sobiesiak, M. (2024). The Role of Selected Elements in Oxidative Stress Protection: Key to Healthy Fertility and Reproduction. International Journal of Molecular Sciences, 25(17), 9409. https://doi.org/10.3390/ijms25179409. [Google Scholar] [Crossref]

128. Xu, J., Hao, Y., Yang, Z., Li, W., Xie, W., Huang, Y., Wang, D., He, Y., Liang, Y., Matsiko, J., & Wang, P. (2022). Rubber Antioxidants and Their Transformation Products: Environmental Occurrence and Potential Impact. 19(21), 14595–14595. https://doi.org/10.3390/ijerph192114595. [Google Scholar] [Crossref]

129. Yan, H., Wang, L., Zhang, G., Li, N., Zhao, Y., Liu, J., Jiang, M., Du, X., Zeng, Q., Xiong, D., He, L., Zhou, Z., Luo, M., & Liu, W. (2024). Oxidative stress and energy metabolism abnormalities in polycystic ovary syndrome: from mechanisms to therapeutic strategies. Reproductive Biology and Endocrinology, 22(1). https://doi.org/10.1186/s12958-024-01337-0. [Google Scholar] [Crossref]

130. Zallen, E. M., Hitchcock, M. J., & Goertz, G. E. (1975). Chilled food systems1: Effects of chilled holding on quality of beef loaves. Journal of the American Dietetic Association, 67(6), 552–557. https://doi.org/10.1016/s0002-8223(21)14836-9. [Google Scholar] [Crossref]

131. Zelko, I. N., Mariani, T. J., & Folz, R. J. (2002). Superoxide dismutase multigene family: a comparison of the CuZn-SOD (SOD1), Mn-SOD (SOD2), and EC-SOD (SOD3) gene structures, evolution, and expression. Free Radical Biology & Medicine, 33(3), 337–349. https://doi.org/10.1016/s0891-5849(02)00905-x. [Google Scholar] [Crossref]

132. Zhang, L., Huang, D., Kondo, M., White, A., & Li, Y. (2019). Widespread role of mitochondrial glutathione in the regulation of mitochondrial function and its identification of a novel mechanistic approach for the treatment of mitochondrial diseases. Free Radical Biology and Medicine, 148, 21-33. [Google Scholar] [Crossref]

133. Zhang, W.; Wu, F. (2023). Effects of adverse fertility-related factors on mitochondrial DNA in the oocyte: A comprehensive review. Reprod. Biol. Endocrinol. 21, 27. [Google Scholar] [Crossref]

134. Zhang, Z.-F., Zhang, X., Sverko, E., Marvin, C. H., Jobst, K. J., Smyth, S. A., & Li, Y.-F. (2020). Determination of Diphenylamine Antioxidants in Wastewater/Biosolids and Sediment. Environmental Science & Technology Letters, 7(2), 102–110. https://doi.org/10.1021/acs.estlett.9b00796 [Google Scholar] [Crossref]

135. видноградова, а., Гіщак, Т., & Маркін, Л. (2023). Оксидативний стрес як провідний патогенетичний фактор чоловічого безпліддя. Репродуктивне здоров’я жінки, (6(64)), 51–57. [Google Scholar] [Crossref]

Metrics

Views & Downloads

Similar Articles

© 2026 IJLTEMAS · RSIS International. All rights reserved. ISSN 2278-2540.