The role of infections and leukocytes in male infertility

Abstract

Oxidative stress is preempted by an adequate level of antioxidants, which scavenge oxidants when they are produced in excess by different sources, including leukocytes and immature spermatozoa. Enzymatic antioxidants, such as superoxide dismutase, catalase and glutathione peroxidase, and several nonenzymatic antioxidants (pro teins, vitamins and minerals), working as oxidant scavengers and cofactors of en zymatic antioxidants have been identified in seminal plasma. The total antioxidant capacity (TAC) is a diagnostic test that can be utilised in the male infertility workup. TAC measures the amount of total antioxidants in seminal plasma. Therefore, it pro vides an assessment of the reductive potential in seminal plasma. Several studies have investigated the diagnostic application of TAC in various andrology conditions. There is substantial evidence in the literature to show that infertile patients have lower seminal TAC in comparison with fertile men. Moreover, there is a positive cor relation between TAC and seminal parameters, such as sperm concentration, motility and morphology. Evaluation of TAC together with reactive oxygen species (ROS) and sperm DNA fragmentation index (DFI) may be beneficial in the diagnosis of male infertility.

Reply to Letter to the Editor by Derakhshan et al. (2021) ‘Vagal nerve stimulation for the treatment of male factor infertility’

“…Further, the possible and unsubstantiated effects of 5‐HT on alleviating male infertility via VNS are beyond the scope of our article (Henkel et al., 2020) and are also contrary to the postulated hypothesis that the VNS‐induced increase in plasma 5‐HT will indeed improve male fertility. There is no evidence for this.…”

“…However, in this context, it is important to mention that most cases of male infertility are not caused by systemic inflammation, but by local inflammation of the MGT. In addition, we were surprised by the authors’ statement that our article (Henkel et al., 2020) ‘introduced’ infection as a contributing factor for male infertility. In fact, it has long been known that after idiopathic infertility and varicocele, MGT infections with about 11.6% are the third single most cause of male infertility (Henkel, 2020; Nieschlag & Behre, 1997), and it is generally accepted that these infections are potentially correctable (Weidner et al., 1999).…”

“…It was with interest and surprise that we read the Letter to the Editors regarding our review paper entitled ‘The role of infections and leukocytes in male infertility’ (Henkel et al., 2020).…”

“…The authors primarily cite Henkel et al. (2020), who reviewed the roles of infections and leukocytes and the potential causes of male genital tract (MGT) inflammation, which could pose a significant challenge to male fertility. In view of this, we review and comment on the above hypothesis and postulates by Derakhshan and colleagues (2021).…”

An update on male infertility: Factors, mechanisms, and interventions

“…They also discuss various aetiologies that increase the risk for OS, such as varicocele and malignancy, and the impact on assisted reproductive outcomes.Henkel et al discuss The Role of Infections and Leukocytes in MaleInfertility in article 3. Leucocytes with or without infection are the major producers of ROS, thereby causing OS and inflammatory damage(Henkel, Offor, & Fisher, 2020).In article 4, Causes and Consequences of SpermMitochondrial Dysfunction, Durairajanayagam et al emphasise the importance of structural and functional integrity of mitochondria in sperm motility and fertilising ability (Durairajanayagam, Singh, Agarwal, & Henkel, 2020). Article 5, How Defective Spermatogenesis Affects Sperm DNA Integrity, presents an overview of spermatogenesis and discusses in detail the sources of sperm DNA damage including replication errors and causes of DNA fragmentation (Kuchakulla, Narasimman, Khodamoradi, Khosravizadeh, & Ramasamy, 2020).…”