Abstract
ObjectivesWe conducted a systematic review and meta-analysis of observational case-control studies to evaluate markers of oxidative stress in seminal plasma of patients with male infertility.BackgroundCurrent evidence links oxidative stress to male infertility, in which multiple markers of oxidative stress have been widely detected, publishing inconsistent results with regard to the role of oxidative stress markers in the evaluation of male infertility. Therefore, a systematic review and meta-analysis on this issue is necessary.ResultsFrom the 1024 articles initially retrieved, 65 studies were included in our meta-analysis with 11 oxidative stress markers, containing 3819 male infertility patients and 2012 controls. The concentrations of malondialdehyde (SMD = 1.86, p < 0.00001), NO (SMD = 0.89, p = 0.001), carbonyl protein (SMD = 2.09, p < 0.00001) in seminal plasma were significantly higher in infertility patients. The concentrations of GSH (SMD = –1.68, p < 0.00001), vitamin C (SMD = –1.12, p < 0.00001), and vitamin E (SMD = –1.48, p = 0.003), as well as the activities of catalase (SMD = –1.91, p < 0.0001), glutathione peroxidase (SMD = –1.96, p = 0.0002) and glutathione-S-transferase (SMD = –1.62, p = 0.009) declined remarkably, resulting in decreased total antioxidant capacity (SMD = –1.77, p < 0.00001). Besides, the activity of superoxide dismutase showed no statistical difference between infertility patients and controls (SMD = –0.51, p = 0.07).ConclusionsOur meta-analysis suggests that oxidative stress in seminal plasma resulting from decreased antioxidant defense are associated with male infertility.MethodsUsing PubMed, EMBASE, CNKI, VIP, and Wanfang database, we searched for literature reporting the detection of oxidative stress markers in the seminal plasma of male infertility published up to June 2017. Standardized mean differences (SMDs) and 95% confidence intervals (95%CI) were calculated for the finally analysis.
Highlights
Infertility has become an increasing medical problem affecting approximately 15% of couples worldwide, of which male factors account for almost 50% cases [1]
From the 1024 articles initially retrieved, 65 studies were included in our meta-analysis with 11 oxidative stress markers, containing 3819 male infertility patients and 2012 controls
The concentrations of malondialdehyde (SMD = 1.86, p < 0.00001), Nitric oxide (NO) (SMD = 0.89, p = 0.001), carbonyl protein (SMD = 2.09, p < 0.00001) in seminal plasma were significantly higher in infertility patients
Summary
Infertility has become an increasing medical problem affecting approximately 15% of couples worldwide, of which male factors account for almost 50% cases [1]. Oxidative stress happens as a result of the excessively reactive oxygen species (ROS) or reactive nitrogen species (RNS) accumulation, due to either increased ROS/RNS generation or impaired ROS/RNS clearance. It will cause extensive sperm DNA damage [11], reduced sperm motility [12], decline in sperm fertilising ability [13], and defective sperm membrane integrity via lipid peroxidation [14], all of which are important mechanisms behind sperm dysfunction. A systematic review and meta-analysis on this issue is necessary
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