“…Its result is statistically significant ( p < 0.001), with MD values of 1.42 µmol/L and heterogeneity coefficient of 99.75% [ 57 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 ]. MDA values have been shown to be significantly higher in men with varicocele or infective diseases in the urogenital tract, which correlates with decreased sperm motility [ 76 ] and higher percentages of necrotic and apoptotic sperm, and heat stress [ 77 ]. This phenomenon can be explained by reduced heat shock proteins and B-cell lymphoma 2 (BCL2) expression, increased BCL2-associated X protein (BAX) expression and higher polymorphism of genes encoding S-glutathione transferase or nitric oxide synthase.…”