While the annual pregnancy probability rate in a healthy couple of fertility age lies between 80 to 85%, up to 15% of these healthy couples fail to achieve pregnancy and give birth (1).

Causes related to the male partner account for nearly half of the cases and are linked mainly to an abnormal semen analysis. This abnormality remains of unexplained origin in almost half of the sub or infertile men (1).

Over the past years, environmental changes and adverse lifestyle factors have greatly contributed to the decline in sperm quality and hence may be incriminated in the increase in male factor sub or infertility (2).

Among these adverse changes, a deficiency in important nutrients involved in sperm normal metabolism has been reported to affect sperm quality and impair its normal functioning and role in fertility (3,4).

Up to 80% of male cause subfertility cases are believed to be the cause of the damaging effects of oxidative stress (5). Oxidative stress happens when reactive oxygen species widely known as “ROS” overcome the semen’s or semen fluid natural antioxidant defenses and thus cause cellular damage to the sperm (5). Indeed, oxidative parameters in the semen of idiopathic infertile men were found to be significantly higher than in fertile men, and a high correlation was seen between oxidative parameters, sperm ROS formation and DNA fragmentation levels (6).

ROS may accumulate due to multiple reasons: Genital infections, illicit drug consumption, cigarette or narguileh (hookah, shisha) smoking, high temperatures, electromagnetic and ionizing radiation, pesticides and pollution, advanced age of marrying males, alcohol consumption, stress, obesity, unhealthy lifestyle and poor diet can cause intrinsic toxicity and generate intense body oxidative stress. Other factors include infections, autoimmunity and chronic disease (7,8)


1-      Ashok Agarwal, Aditi Mulgund, Alaa Hamada, and Michelle Renee Chyatte. A unique view on male infertility around the globe. Reprod Biol Endocrinol. 2015; 13: 37

2-      Carlsen E, Giwercman A, Keiding N, Skakkebaek NE. Evidence for decreasing quality of semen during past 50 years. BMJ. 1992;305: 609–13.

3-      Kumar R, Gautam G, Gupta NP. Drug therapy for idiopathic male infertility: rationale versus evidence. J Urol. 2006; 176: 1307-1312

4-      Wong WY, Thomas CM, Merkus JM, et al. Male factor subfertility: possible causes and the impact of nutritional factors. Fertil Steril. 2000; 73: 435-442

5-      Tremellen K. Oxidative stress and male infertility – a clinical perspective. Human Reproduction Update 2008;14(3): 243–58.

6-      Aktan G, Dogru-Abbasoglu S, Kucukgergin C, Kadioglu A, Ozdemirler-Erata G, Kocak-Toker N. Mystery of idiopathic male infertility: is oxidative stress an actual risk? Fertility and Sterility 2013;99(5):1211–5.

7-      Aitken RJ, De Iuliis GN. Origins and consequences of DNA damage in male germ cells. Reproductive Biomedicine Online 2007;14(6):727–33.

8-      Alvarez 2003. Nuture vs nature: How can we optimize sperm quality? Journal of Andrology 2003;24(5):640–8.

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