| Abstract [eng] |
SUMMARY Vilnius University Faculty of Medicine Clinic of Gastroenterology, Nephro-Urology and Surgery Application of Antioxidant Therapy in Treatment of Male Fertility Disorders (Literature Review) The Author: Pijus Mikailas Academic supervisor: dr. Albertas Čekauskas The aim of research work: To review the clinical features of antioxidant therapy for the treatment of male fertility disorders, based on the most recent scientific literature. Tasks of work: 1. To assess the role of oxidative stress in male fertility disorders. 2. To review the diagnostic options for assessing oxidative stress. 3. To determine the efficacy of antioxidants in improving fertility-related parameters. Materials and methods: The literature search was conducted between July 2024 and January 2025 using PubMed, Google Scholar databases. The literature sources used in the sections of the paper describing the association between oxidative stress and fertility, diagnostic features of oxidative stress, mechanisms of antioxidant action, and a review of redox stress were chosen without applying strict criteria for selection. In contrast, the clinical trials analysed in the 4.3-4.12 sections were selected using inclusion and exclusion criteria. These studies were carefully described and the information was presented in tables. Results: The scientific literature reviewed unanimously agrees that oxidative stress plays an important role in the majority of fertility-related problems. Varicocele, infections, metabolic syndrome, alcohol and smoking are the main aetiological factors contributing to the development of oxidative stress and the resulting fertility problems. Although diagnostic tools are currently available to assess the level of oxidative stress, such tools are not based on clinical trials or are difficult to apply in daily clinical practice. One of the proposed treatments for fertility problems6 related to oxidative stress is antioxidant therapy. In this paper, 27 randomised controlled trials evaluating the effectiveness of antioxidant therapy in modifying various fertility parameters were analysed using inclusion and exclusion criteria. 77.8% (21) of all these trials showed a positive effect of antioxidant therapy. However, the small sample sizes, short study periods and sub-optimal outcomes evaluated are major limitations of these studies, and the validity of antioxidant therapies remains unclear.. The phenomenon of redox stress has also been discussed as a possible side effect of antioxidant therapy, but the clinical relevance of this phenomenon is not supported by scientific studies. Conclusions: 1. Oxidative stress is an important pathophysiological factor in many male fertility disorders, with both extrinsic and intrinsic aetiological factors contributing to its development. 2. The routine use of currently available diagnostic tools to assess oxidative stress levels is not clinically valid and is therefore not recommended. 3. Although most of the clinical trials that have been carried out show the effectiveness of antioxidant therapy in improving a wide range of fertility parameters, there are serious limitations to the research. 4. The small sample size and short study period are the main drawbacks of the studies that have analysed the effectiveness of antioxidants. |
