Male Infertility

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Male infertility

Infertility worldwide

Infertility is estimated to affect around 190 million people worldwide.1 Although male infertility contributes to at least 50% of all infertility cases worldwide, very frequently infertility remains a woman’s social burden2. With the recent rise of artificial reproductive technologies it is mostly women whose reproductive health and function is intensely examined and treated, possibly leaving another 50% of the potential causes for impaired fertility uncovered.

Male Infertility

A multitude of factors contributes to the increasing prevalence of male infertility. Causes such as varicocele, hypogonadism, urinary tract infections and systemic diseases are known and can be easily diagnosed.

However, contemporary environmental and lifestyle factors add new layers of complexities to this condition. Despite a high percentage of causes successfully diagnosed, around 50% of all male infertility causes remain categorized as idiopathic.3

Idiopathic infertility: „In men with idiopathic infertility, despite completing diagnostic investigations, the cause of altered semen parameters cannot be identified.“4

A new generation of diagnostic tools and therapeutic approaches is necessary to remove further uncertainty around male infertility, improve its diagnosis and management.

Oxidative Stress and Male Infertility

„Male reproductive potential cannot be adequately assessed if seminal Oxidative Stress is overlooked.“3

„Oxidative stress is likely to be an important modulator of human sperm function and conception outcomes“7

Sperm oxidation

An abundance of evidence suggests that oxidative stress plays a significant role in the etiology of male infertility.

In human semen, oxidative stress results from a homeostatic disbalance between the production of reactive oxygen species (ROS) and total antioxidant capacity to neutralize them.7 This disbalance can occur due to multiple internal and external factors, and is highly influenced by one‘s environment and lifestyle choices.

Up to 50% of all male infertility cases are categorized as Idiopathic, and Oxidative Stress is present in up to 80% of such patients.8

In addition to idiopathic infertility, pathologies such as urinary tract infection, chronic prostatitis, varicocele, testicular torsion, and cryptorchidism are well-established causes of seminal oxidative stress.9

Oxidative Stress interferes with various critical sperm functions and may affect the sperm’s potential to successfully fertilize an egg and generate a good quality embryo.10

The most recent literature suggests that an estimated number of around 55 million men worldwide could be diagnosed with MOSI (Male Oxidative Stress Infertility).

Most importantly if diagnosed and managed correctly, MOSI is a potentially treatable condition.11

MiOXSYS®

The most up-to-date diagnostic guidelines recommend that men with idiopathic infertility should be screened for MOSI using an efficient, high sensitivity/specificity oxidative stress test – MiOXSYS®, which measures patients‘ oxidation-reduction potential (ORP) and has practical advantages over alternative techniques.12

Mioxsys device

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References

1 Agarwal A, Parekh N, Panner Selvam MK, et al. Male Oxidative Stress Infertility (MOSI): Proposed Terminology and Clinical Practice Guidelines for Management of Idiopathic Male Infertility. World J Men‘s Health. 2019;37(3):296-312. doi:10.5534/wjmh.190055

2 Inhorn MC, Patrizio P. Infertility around the globe: new thinking on gender, reproductive technologies and global movements in the 21st century. Hum Reprod Update. 2015 Jul-Aug;21(4):411-26. doi: 10.1093/humupd/dmv016. Epub 2015 Mar 22. PMID: 25801630.

3 Agarwal A, Parekh N, Panner Selvam MK, et al. Male Oxidative Stress Infertility (MOSI): Proposed Terminology and Clinical Practice Guidelines for Management of Idiopathic Male Infertility. World J Men‘s Health. 2019;37(3):296-312. doi:10.5534/wjmh.190055

4 Agarwal A, Baskaran S, Parekh N, et al. Male infertility. Lancet. 2021;397(10271):319-333. doi:10.1016/S0140-6736(20)32667-2

5 Agarwal A, Parekh N, Panner Selvam MK, et al. Male Oxidative Stress Infertility (MOSI): Proposed Terminology and Clinical Practice Guidelines for Management of Idiopathic Male Infertility. World J Men‘s Health. 2019;37(3):296-312. doi:10.5534/wjmh.190055

6 World Health Organisation Laboratory Manual for the Examination and Processing of Human Semen (6th. Ed), 2021

7 Takeshima T, Usui K, Mori K, et al. Oxidative stress and male infertility. Reprod Med Biol. 2020;20(1):41-52. Published 2020 Oct 18. doi:10.1002/rmb2.12353

8 Agarwal A, Parekh N, Panner Selvam MK, et al. Male Oxidative Stress Infertility (MOSI): Proposed Terminology and Clinical Practice Guidelines for Management of Idiopathic Male Infertility. World J Mens Health. 2019;37(3):296-312. doi:10.5534/wjmh.190055

9 Meinhardt A. Andrology 3rd edition—E. Nieschlag, H.M. Behre, S. Nieschlag (eds). Asian J Androl. 2010;12(3):458. doi:10.1038/aja.2010.27

10 Takeshima T, Usui K, Mori K, et al. Oxidative stress and male infertility. Reprod Med Biol. 2020;20(1):41-52. Published 2020 Oct 18. doi:10.1002/rmb2.12353

11 Agarwal A, Parekh N, Panner Selvam MK, et al. Male Oxidative Stress Infertility (MOSI): Proposed Terminology and Clinical Practice Guidelines for Management of Idiopathic Male Infertility. World J Mens Health. 2019;37(3):296-312. doi:10.5534/wjmh.190055

12 Ibid