The World Journal of Men's Health (Sep 2019)
Male Oxidative Stress Infertility (MOSI): Proposed Terminology and Clinical Practice Guidelines for Management of Idiopathic Male Infertility
- Ashok Agarwal,
- Neel Parekh,
- Manesh Kumar Panner Selvam,
- Ralf Henkel,
- Rupin Shah,
- Sheryl T. Homa,
- Ranjith Ramasamy,
- Edmund Ko,
- Kelton Tremellen,
- Sandro Esteves,
- Ahmad Majzoub,
- Juan G. Alvarez,
- David K. Gardner,
- Channa N. Jayasena,
- Jonathan W. Ramsay,
- Chak-Lam Cho,
- Ramadan Saleh,
- Denny Sakkas,
- James M. Hotaling,
- Scott D. Lundy,
- Sarah Vij,
- Joel Marmar,
- Jaime Gosalvez,
- Edmund Sabanegh,
- Hyun Jun Park,
- Armand Zini,
- Parviz Kavoussi,
- Sava Micic,
- Ryan Smith,
- Gian Maria Busetto,
- Mustafa Emre Bakırcıoğlu,
- Gerhard Haidl,
- Giancarlo Balercia,
- Nicolás Garrido Puchalt,
- Moncef Ben-Khalifa,
- Nicholas Tadros,
- Jackson Kirkman-Browne,
- Sergey Moskovtsev,
- Xuefeng Huang,
- Edson Borges Jr,
- Daniel Franken,
- Natan Bar-Chama,
- Yoshiharu Morimoto,
- Kazuhisa Tomita,
- Vasan Satya Srini,
- Willem Ombelet,
- Elisabetta Baldi,
- Monica Muratori,
- Yasushi Yumura,
- Sandro La Vignera,
- Raghavender Kosgi,
- Marlon P. Martinez,
- Donald P. Evenson,
- Daniel Suslik Zylbersztejn,
- Matheus Roque,
- Marcello Cocuzza,
- Marcelo Vieira,
- Assaf Ben-Meir,
- Raoul Orvieto,
- Eliahu Levitas,
- Amir Wiser,
- Mohamed Arafa,
- Vineet Malhotra,
- Sijo Joseph Parekattil,
- Haitham Elbardisi,
- Luiz Carvalho,
- Rima Dada,
- Christophe Sifer,
- Pankaj Talwar,
- Ahmet Gudeloglu,
- Ahmed M.A. Mahmoud,
- Khaled Terras,
- Chadi Yazbeck,
- Bojanic Nebojsa,
- Damayanthi Durairajanayagam,
- Ajina Mounir,
- Linda G. Kahn,
- Saradha Baskaran,
- Rishma Dhillon Pai,
- Donatella Paoli,
- Kristian Leisegang,
- Mohamed-Reza Moein,
- Sonia Malik,
- Onder Yaman,
- Luna Samanta,
- Fouad Bayane,
- Sunil K. Jindal,
- Muammer Kendirci,
- Baris Altay,
- Dragoljub Perovic,
- Avi Harlev
Affiliations
- Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic
- Neel Parekh
- Department of Urology, Cleveland Clinic, Cleveland, OH, USA
- Manesh Kumar Panner Selvam
- American Center for Reproductive Medicine, Cleveland Clinic
- Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic
- Rupin Shah
- Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
- Sheryl T. Homa
- School of Biosciences, University of Kent, Canterbury, UK
- Ranjith Ramasamy
- Department of Urology, University of Miami, Miami, FL
- Edmund Ko
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
- Kelton Tremellen
- Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders University, Bedford Park, Australia
- Sandro Esteves
- Division of Urology, Department of Surgery, University of Campinas (UNICAMP), Campinas, Brazil
- Ahmad Majzoub
- American Center for Reproductive Medicine, Cleveland Clinic
- Juan G. Alvarez
- Centro Androgen, La Coruña, Spain and Harvard Medical School, Boston, MA, USA
- David K. Gardner
- School of BioSciences, University of Melbourne, Parkville, Australia
- Channa N. Jayasena
- Section of Investigative Medicine, Imperial College London
- Jonathan W. Ramsay
- Department of Andrology, Hammersmith Hospital, London, UK,
- Chak-Lam Cho
- Department of Surgery, Union Hospital, Shatin, Hong Kong
- Ramadan Saleh
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
- Denny Sakkas
- Boston IVF, Waltham, MA
- James M. Hotaling
- Department of Urology, University of Utah, Salt Lake City, UT
- Scott D. Lundy
- Department of Urology, Cleveland Clinic, Cleveland, OH, USA
- Sarah Vij
- Department of Urology, Cleveland Clinic, Cleveland, OH, USA
- Joel Marmar
- Cooper University Hospital, Camden, NJ, USA
- Jaime Gosalvez
- Departamento de Biología, Universidad Autónoma de Madrid, Madrid, Spain,
- Edmund Sabanegh
- Department of Urology, Cleveland Clinic, Cleveland, OH, USA
- Hyun Jun Park
- Department of Urology, Pusan National University School of Medicine
- Armand Zini
- Department of Surgery, McGill University, Montreal, QC, Canada
- Parviz Kavoussi
- Austin Fertility & Reproductive Medicine/Westlake IVF, Austin, TX, USA
- Sava Micic
- Uromedica Polyclinic, Kneza Milosa, Belgrade, Serbia
- Ryan Smith
- Department of Urology, University of Virginia, Charlottesville, VA, USA
- Gian Maria Busetto
- Sapienza University of Rome, Rome, Italy
- Mustafa Emre Bakırcıoğlu
- Istanbul Florence Nightingale Hospital, Istanbul, Turkey
- Gerhard Haidl
- Department of Dermatology, University Hospital Bonn, Bonn, Germany
- Giancarlo Balercia
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Umberto I Hospital, Ancona, Italy
- Nicolás Garrido Puchalt
- IVI Foundation Edificio Biopolo – Instituto de Investigación Sanitaria la Fe, Valencia, Spain
- Moncef Ben-Khalifa
- University Hospital, School of Médicine and PERITOX Laboratory, Amiens, Frances
- Nicholas Tadros
- Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
- Jackson Kirkman-Browne
- Centre for Human Reproductive Science, IMSR, College of Medical & Dental Sciences, The University of Birmingham Edgbaston
- Sergey Moskovtsev
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada
- Xuefeng Huang
- Reproductive Medicine Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Edson Borges Jr
- Fertility Medical Group, São Paulo, Brazil
- Daniel Franken
- Department of Obstetrics & Gynecology, Andrology Unit Faculties of Health Sciences, Tygerberg Hospital, Tygerberg, South Africa
- Natan Bar-Chama
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Yoshiharu Morimoto
- IVF Japan Group, Horac Grand Front Osaka Clinic, Osaka, Japan
- Kazuhisa Tomita
- IVF Japan Group, Horac Grand Front Osaka Clinic, Osaka, Japan
- Vasan Satya Srini
- Manipal Fertility, Bangalore, India
- Willem Ombelet
- Genk Institute for Fertility Technology, Genk
- Elisabetta Baldi
- Department of Experimental and Clinical Medicine, Center of Excellence DeNothe, University of Florence
- Monica Muratori
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, Unit of Sexual Medicine and Andrology, Center of Excellence DeNothe, University of Florence, Florence, Italy
- Yasushi Yumura
- Department of Urology, Reproduction Center, Yokohama City University Medical Center, Yokohama, Japan
- Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Raghavender Kosgi
- Androbest Andrology & Urology Center, Hyderabad, India
- Marlon P. Martinez
- Section of Urology, University of Santo Tomas Hospital, Manila, Philippines
- Donald P. Evenson
- SCSA Diagnostics, Brookings, SD, USA
- Daniel Suslik Zylbersztejn
- Fleury Group and Hospital Israelita Albert Einstein, São Paulo
- Matheus Roque
- Origen, Center for Reproductive Medicine, Rio de Janeiro
- Marcello Cocuzza
- Department of Urology, University of São Paulo (USP)
- Marcelo Vieira
- Division of Urology, Infertility Center ALFA, São Paulo
- Assaf Ben-Meir
- Fertility and IVF Unit, Department of Obstetrics and Gynecology, Hebrew-University Hadassah Medical Center, Jerusalem
- Raoul Orvieto
- Infertility and IVF Unit, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel Hashomer), Ramat Gan
- Eliahu Levitas
- Soroka University Medical Center, Ben-Gurion University of the Negev Beer-Sheva, Beersheba
- Amir Wiser
- IVF Unit, Meir Medical Center, Kfar Sava
- Mohamed Arafa
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Vineet Malhotra
- Department of Andrology and Urology, Diyos Hospital, New Delhi, India
- Sijo Joseph Parekattil
- PUR Clinic, South Lake Hospital, Clermont
- Haitham Elbardisi
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Luiz Carvalho
- Baby Center, Institute for Reproductive Medicine
- Rima Dada
- Lab for Molecular Reproduction and Genetics, Anatomy, All India Institute of Medical Sciences, New Delhi, India
- Christophe Sifer
- Department of Reproductive Biology, Hôpitaux Universitaires Paris Seine Saint-Denis, Bondy, France
- Pankaj Talwar
- Department of Reproductive Medicine and Embryology, Manipal Hospital, New Delhi, India
- Ahmet Gudeloglu
- Department of Urology, Hacettepe University Faculty of Medicine, Ankara, Turkey
- Ahmed M.A. Mahmoud
- Department of Endocrinology/ Andrology, University Hospital Ghent, Ghent, Belgium,
- Khaled Terras
- Department of Reproductive Medicine, Hannibal International Clinic, Tunis, Tunisia
- Chadi Yazbeck
- Department of Obstetrics, Gynecology and Reproductive Medicine, Pierre Cherest and Hartman Clinics, Paris, France
- Bojanic Nebojsa
- Clinic of Urology, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Damayanthi Durairajanayagam
- Department of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, Selangor, Malaysia
- Ajina Mounir
- Department of Embryology, Faculty of Medicine, University of Sousse, Sousse, Tunisia
- Linda G. Kahn
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA
- Saradha Baskaran
- American Center for Reproductive Medicine, Cleveland Clinic
- Rishma Dhillon Pai
- Department of Obstetrics and Gynaecology, Lilavati Hospital and Research Centre, Mumbai, India
- Donatella Paoli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
- Kristian Leisegang
- School of Natural Medicine, University of the Western Cape, Cape Town, South Africa
- Mohamed-Reza Moein
- Department of Andrology, Shahid Sadoughi Medical University, Yazd, Iran
- Sonia Malik
- Southend Fertility & IVF, Delhi, India
- Onder Yaman
- Department of Urology, School of Medicine, University of Ankara, Ankara, Turkey
- Luna Samanta
- Redox Biology Laboratory, Department of Zoology and Center of Excellence in Environment and Public Health, Ravenshaw University, Cutrack, India
- Fouad Bayane
- Marrakech Fertility Institute, Marrakech, Morocco
- Sunil K. Jindal
- Jindal Hospital, Meerut, India
- Muammer Kendirci
- Department of Urology, Istinye University Faculty of Medicine, Liv Hospital Ulus, Istanbul
- Baris Altay
- Department of Urology, Ege University School of Medicine, İzmir, Turkey
- Dragoljub Perovic
- Center of Urology, CODRA Hospital, Podgorica, Montenegro
- Avi Harlev
- Fertility and IVF Unit, Soroka University Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel
- DOI
- https://doi.org/10.5534/wjmh.190055
- Journal volume & issue
-
Vol. 37,
no. 3
pp. 296 – 312
Abstract
Despite advances in the field of male reproductive health, idiopathic male infertility, in which a man has altered semen characteristics without an identifiable cause and there is no female factor infertility, remains a challenging condition to diagnose and manage. Increasing evidence suggests that oxidative stress (OS) plays an independent role in the etiology of male infertility, with 30% to 80% of infertile men having elevated seminal reactive oxygen species levels. OS can negatively affect fertility via a number of pathways, including interference with capacitation and possible damage to sperm membrane and DNA, which may impair the sperm’s potential to fertilize an egg and develop into a healthy embryo. Adequate evaluation of male reproductive potential should therefore include an assessment of sperm OS. We propose the term Male Oxidative Stress Infertility, or MOSI, as a novel descriptor for infertile men with abnormal semen characteristics and OS, including many patients who were previously classified as having idiopathic male infertility. Oxidation-reduction potential (ORP) can be a useful clinical biomarker for the classification of MOSI, as it takes into account the levels of both oxidants and reductants (antioxidants). Current treatment protocols for OS, including the use of antioxidants, are not evidence-based and have the potential for complications and increased healthcare-related expenditures. Utilizing an easy, reproducible, and cost-effective test to measure ORP may provide a more targeted, reliable approach for administering antioxidant therapy while minimizing the risk of antioxidant overdose. With the increasing awareness and understanding of MOSI as a distinct male infertility diagnosis, future research endeavors can facilitate the development of evidence-based treatments that target its underlying cause.
Keywords
