Oxidative Stress and Idiopathic Male Infertility

Idiopathic male infertility (IMI) refers to the condition where semen quality declines, but exact causatives are not identified. This occurs in almost 30–40% of infertile men. Traditional semen analyses are extensively used for determining semen quality, but these bear critical shortcomings such as poor reproducibility, subjectivity, and reduced prediction of fertility. Oxidative stress (OS) has been identified as the core common mechanism by which various endogenous and exogenous factors may induce IMI. Male oxidative stress infertility (MOSI) is a term used to describe infertile males with abnormal semen parameters and OS. For the treatment of MOSI, antioxidants are mostly used which counteract OS and improve sperm parameters with appropriate combinations, dosage, and duration. Diagnosis and management of male infertility have witnessed a substantial improvement with the advent in the omics technologies that address at genetic, molecular, and cellular levels. Incorporation of oxidation-reduction potential (ORP) can be a useful clinical biomarker for MOSI. Moreover, various modulations of male fertility status can be achieved via stem cell and next-generation sequencing (NGS) technologies. However, several challenges must be overcome before the advanced techniques can be utilized to address IMI, including ethical and religious considerations, as well as the possibility of genetic abnormalities. Considering the importance of robust understanding of IMI, its diagnosis, and possible advents in management, the present article reviews and updates the available information in this realm, emphasizes various facets of IMI, role of OS in its pathophysiology, and discusses the novel concept of MOSI with a focus on its diagnostic and therapeutic aspects.