Cited by 261Sperm and Testicular FunctionMale Reproductive Health StudiesAntioxidant Activity and Oxidative Stress

The DOI matches its Crossref record.

Relationship between oxidative stress, varicocele and infertility: a meta-analysis

Open access

Agarwal, Ashok, Prabakaran, Sushil, Allamaneni, Shyam SSR·2006·Reproductive BioMedicine Online

Open this paper in CoChat — free account

Abstract

Varicocele is one of the leading causes of male infertility, and is present in almost 40% of infertile males. Recent understanding of the role of oxidative stress in male reproduction has led some researchers to postulate oxidative stress as the possible cause of sperm dysfunction in varicocele patients. The objective of the present study was to examine the published literature on the role of oxidative stress in patients with varicocele as the aetiology of their infertility. Twenty-three human studies were identified after an extensive search dealing with the role of oxidative stress in varicocele-associated infertility. Out of these studies, four were selected that measured similar types of reactive oxygen species (ROS) by a similar method of measurement. The data were then entered in the RevMan software for analysis. The overall estimate showed that patients have significantly higher concentrations of ROS than controls, with the mean difference being 0.73 (95% CI 0.40, 1.06, P < 0.0001). This translated to an ROS concentration of 4.37 x 10(4) cpm/20 x 10(6) spermatozoa/ml on the linear scale. Total antioxidant capacity levels were found to be significantly lower in the infertile varicocele patients, with 386 fewer trolox equivalents than the controls (95% CI -556.56-216.96, P < 0.00001). From the results, it can be concluded that there is increased oxidative stress in varicocele patients; however, more studies are needed to confirm this finding.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1016/s1472-6483(10)61190-x

Cites

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

No references could be resolved yet.

Research works printed but not linked: 19

Agarwal, 2005, Mechanism, measurement, and prevention of oxidative stress in male reproductive physiology, Indian Journal of Experimental Biology, 43, 963
Agarwal, 2005, Role of oxidative stress in female reproduction, Reproductive Biology and Endocrinology, 3, 28, 10.1186/1477-7827-3-28 · DOI · Paper page
Allamaneni, 2004, Increased seminal reactive oxygen species levels in patients with varicoceles correlate with varicocele grade but not with testis size, Fertility and Sterility, 82, 1684, 10.1016/j.fertnstert.2004.04.071 · DOI
Benoff, 2004, Bilateral increased apoptosis and bilateral accumulation of cadmium in infertile men with left varicocele, Human Reproduction, 19, 616, 10.1093/humrep/deh139 · DOI
Esfandiari, 2003, Utility of the nitroblue tetrazolium reduction test for assessment of reactive oxygen species production by seminal leukocytes and spermatozoa, Journal of Andrology, 24, 862, 10.1002/j.1939-4640.2003.tb03137.x · DOI
Goldstein, 1989, Elevation of intratesticular and scrotal skin surface temperature in men with varicocele, Journal of Urology, 142, 743, 10.1016/S0022-5347(17)38874-2 · DOI
Hendin, 1999, Varicocele is associated with elevated spermatozoal reactive oxygen species production and diminished seminal plasma antioxidant capacity, Journal of Urology, 161, 1831, 10.1016/S0022-5347(05)68818-0 · DOI
Kim, 1999, Varicocele repair improves semen parameters in azoospermic men with spermatogenic failure, Journal of Urology, 162, 737, 10.1097/00005392-199909010-00031 · DOI
Lue, 1999, Single exposure to heat induces stage-specific germ cell apoptosis in rats: role of intratesticular testosterone on stage specificity, Endocrinology, 140, 1709, 10.1210/en.140.4.1709 · DOI
Madgar, 1995, Controlled trial of high spermatic vein ligation for varicocele in infertile men, Fertility and Sterility, 63, 120, 10.1016/S0015-0282(16)57306-3 · DOI
Mostafa, 2001, Varicocelectomy reduces reactive oxygen species levels and increases antioxidant activity of seminal plasma from infertile men with varicocele, International Journal of Andrology, 24, 261, 10.1046/j.1365-2605.2001.00296.x · DOI
Pasqualotto, 2000, Relationship between oxidative stress, semen characteristics, and clinical diagnosis in men undergoing infertility investigation, Fertility and Sterility, 73, 459, 10.1016/S0015-0282(99)00567-1 · DOI
Said, 2003, Enhanced chemiluminescence assay versus colorimetric assay for measurement of the total antioxidant capacity of human seminal plasma, Journal of Andrology, 24, 676, 10.1002/j.1939-4640.2003.tb02726.x · DOI
Saleh, 2003, Evaluation of nuclear DNA damage in spermatozoa from infertile men with varicocele, Fertility and Sterility, 80, 1431, 10.1016/S0015-0282(03)02211-8 · DOI
Saypol, 1981, Influence of surgically induced varicocele on testicular blood flow, temperature, and histology in adult rats and dogs, Journal of Clinical Investigation, 68, 39, 10.1172/JCI110252 · DOI
Schoor, 2001, The pathophysiology of varicocele-associated male infertility, Current Urology Reports, 2, 432, 10.1007/s11934-001-0035-7 · DOI
Sharma, 1999, The reactive oxygen species-total antioxidant capacity score is a new measure of oxidative stress to predict male infertility, Human Reproduction, 14, 2801, 10.1093/humrep/14.11.2801 · DOI
Skoog, 1997, The adolescent varicocele: what's new with an old problem in young patients?, Pediatrics, 100, 112, 10.1542/peds.100.1.112 · DOI
Zini, 2005, Beneficial effect of microsurgical varicocelectomy on human sperm DNA integrity, Human Reproduction, 20, 1018, 10.1093/humrep/deh701 · DOI

Sorted by citations

Items 101–200 of 208

Should the current guidelines for the treatment of varicoceles in infertile men be re-evaluated?
Yan, S., Shabbir, M., Yap, T., Homa, S., Ramsay, J., McEleny, K., & Minhas, S. (2019) · Human Fertility · doi:10.1080/14647273.2019.1582807 · Cited by 20
“Several studies have shown that both infertile men and fertile men with varicoceles have significantly elevated seminal ROS and lower TAC compared to those without varicoceles (Agarwal et al., 2006; Hendin et al., 1999; Sakamoto, Ishikawa, Kondo, Yamaguchi, & Fujisawa, 2008; Sharma, Pasqualotto, Nelson, Thomas, & Agar…”
BackgroundInfluential
Diquat causes mouse testis injury through inducing heme oxygenase-1-mediated ferroptosis in spermatogonia
Cheng, J., Yang, L., Zhang, Z., Xu, D., Hua, R., Chen, H., Li, X., Duan, J., & Li, Q. (2024) · Ecotoxicology and Environmental Safety · doi:10.1016/j.ecoenv.2024.116562 · Cited by 17
Effect of oxygen and glucose availability during in vitro maturation of bovine oocytes on development and gene expression
Whitty, A., Kind, K., Dunning, K. R., & Thompson, J. G. (2021) · Journal of Assisted Reproduction and Genetics · doi:10.1007/s10815-021-02218-w · Cited by 18
Scientific landscape of oxidative stress in male reproductive research: A scientometric study
Agarwal, A. K., Baskaran, S., Selvam, M. K. P., Finelli, R., Zenoaga-Barbăroşie, C., Robert, K. A., Iovine, C., Master, K., & Henkel, R. (2020) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2020.05.008 · Cited by 17
Self-citation
Role of Antioxidant in Testicular Integrity
Dare, B. (2014) · Annual Research & Review in Biology · doi:10.9734/arrb/2014/4453 · Cited by 17
“In clinical studies, the presence of a varicocele has been shown to correlate with excess ROS generation by the spermatozoa, high rates of DNA damage in these cells and depleted antioxidant levels in the seminal plasma [117,118,119].”
Background
Don't wait any longer, conceive in time: a systematic review and meta-analysis based on semen parameters after varicocelectomy
Mei, Y.-Y., Ji, N., Feng, X.-L., Xu, R.-F., & Xue, D. (2024) · International Urology and Nephrology · doi:10.1007/s11255-024-04080-y · Cited by 16
“Among several proposed mechanisms, the most commonly accepted one was that oxidative stress due to varicocele reduces spermatogenesis [28].”
Background
Sperm DNA status in infertile patients with clinical varicocele.
Jellad, S., Hammami, F., Khalbous, A., Messousi, M., Khiari, R., Ghozzi, S., & Chibani, M. (2020) · Progrès en urologie (Paris) · doi:10.1016/j.purol.2020.07.241 · Cited by 16
The effects of high and low doses of folic acid on oxidation of protein levels during pregnancy: a randomized double-blind clinical trial
Shiralizadeh, J., Barmaki, H., Haiaty, S., Faridvand, Y., Mostafazadeh, M., Mokarizadeh, N., Kamrani, A., Isazadeh, A., & Maroufi, N. F. (2017) · Hormone Molecular Biology and Clinical Investigation · doi:10.1515/hmbci-2017-0039 · Cited by 19
Gelatinases and their tissue inhibitors are associated with oxidative stress: a potential set of markers connected with male infertility.
Kratz, E., Kałuża, A., Ferens-Sieczkowska, M., Olejnik, B., Fiutek, R., Zimmer, M., & Piwowar, A. (2016) · Reproduction, Fertility and Development · doi:10.1071/rd14268 · Cited by 16
“TAC levels have been also studied before (Agarwal et al. 2006; Mahfouz et al. 2009; Aktan et al. 2013; Pahune et al. 2013), but there is no information about AOPP levels.”
Background
Seminal plasma levels of free 8-isoprostane and its relationship with sperm quality parameters
Khosrowbeygi, A., & Zarghami, N. (2008) · Indian Journal of Clinical Biochemistry · doi:10.1007/s12291-008-0012-8 · Cited by 15
The mechanism of oxidative stress in asthenozoospermia and antioxidant strategies: a review
Mo, L., Wu, H., Zhang, M., Zhang, P., Peng, W., He, Y., & Gao, F. (2025) · Frontiers in Endocrinology · doi:10.3389/fendo.2025.1670762 · Cited by 20
Improvement in sperm quality by oral antioxidant supplementation in infertile men with varicocele who have not undergone surgical repair: Systematic review and meta‐analysis
Ioannidou, P., Papanikolaou, D., Bosdou, J., Goulis, D., Lambropoulos, A., Grimbizis, G., & Kolibianakis, E. (2022) · Andrologia · doi:10.1111/and.14533 · Cited by 14
“Moreover, patients with VCL are characterized by low concentration of antioxidants and elevated reactive oxygen species (ROS) concentrations (Agarwal et al., 2006; Su et al., 2021).”
Background
Oxidation reduction potential: a new biomarker of male infertility.
Martins, A., & Agarwal, A. (2019) · Panminerva Medica (Testo stampato) · doi:10.23736/s0031-0808.18.03529-2 · Cited by 14
Self-citation
From oxidative imbalance to compromised standard sperm parameters: Toxicological aspect of phthalate esters on spermatozoa
Mondal, S., & Bandyopadhyay, A. (2023) · Environmental Toxicology and Pharmacology · doi:10.1016/j.etap.2023.104085 · Cited by 20
Predictors of pregnancy and time to pregnancy in infertile men with idiopathic oligoasthenospermia pre‐ and post‐coenzyme Q10 therapy
Alahmar, A. T., & Naemi, R. (2022) · Andrologia · doi:10.1111/and.14385 · Cited by 18
Water and Food restriction decreases immunoreactivity of oestrogen receptor alpha and antioxidant activity in testes of sexually mature Coturnix coturnix japonica.
Baghel, K., Niranjan, M. K., & Srivastava, R. (2020) · Journal of animal physiology and animal nutrition · doi:10.1111/jpn.13394 · Cited by 13
Supraphysiological Free Radical Levels and their Pathogenesis in Male Infertility
V, D. (2012) · doi:10.4172/2161-038x.1000114 · Cited by 13
Short-term levosimendan treatment protects rat testes against oxidative stress
Yuksel, M., Kavak, S., Gecit, İ., Basel, H., Gümrükçüoğlu, H. A., Demir, H., & Meral, I. (2012) · Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas · doi:10.1590/s0100-879x2012007500075 · Cited by 13
Experimental Varicocele Induces p53-Dependent Germ Cell Apoptosis through Activation of γ-H2AX
Chang, I., Kim, J.-H., Park, K., & Yoon, S. (2010) · Urologia internationalis · doi:10.1159/000316356 · Cited by 13
“Significantly increased oxidative stress parameters are also evidenced in the testes and the spermatozoa of varicocele patients [”
Background
The characterization of CellROX™ probes could be a crucial factor in ram sperm quality assessment
Palacin-Martinez, C., Anel-López, L., Alvarez, M., Neila-Montero, M., Montes-Garrido, R., Soriano-Úbeda, C., de Paz, P., Anel, L., & Riesco, M. F. (2024) · Frontiers in Veterinary Science · doi:10.3389/fvets.2024.1342808 · Cited by 12
The Role and Place of Antioxidants in the Treatment of Male Infertility Caused by Varicocele
Szymanski, M., Domaracki, P., Szymańska, A., Wandtke, T., Szyca, R., Brycht, Ł., Wasilow, K., & Skorupski, W. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11216391 · Cited by 12
Microsurgical Management of Male Infertility: Compelling Evidence That Collaboration with Qualified Male Reproductive Urologists Enhances Assisted Reproductive Technology (ART) Outcomes
Marinaro, J., & Goldstein, M. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11154593 · Cited by 12
Characterization of varicocele-induced animal models: Potential role of inflammasome complex in the varicocele pathophysiology.
Nogueira, G. A. K. A., Maciel, V. L., Minas, A., & Antoniassi, M. (2021) · Journal of Reproductive Immunology · doi:10.1016/j.jri.2021.103442 · Cited by 12
Varicocele Repair Prior to Assisted Reproductive Technology: Patient Selection and Special Considerations
Kohn, J., Haney, N., Nichols, P., Rodriguez, K. M., & Kohn, T. (2020) · Research and Reports in Urology · doi:10.2147/rru.s198934 · Cited by 12
Autophagy related gene expression status in patients diagnosed with azoospermia: A cross‐sectional study
Asgari, R., Bakhtiari, M., Rezazadeh, D., Vaisi‐Raygani, A., & Mansouri, K. (2020) · The Journal of Gene Medicine · doi:10.1002/jgm.3161 · Cited by 14
“infection, sperm agglutination, tumors, hormonal imbalance, varicocele, ejaculation issues and sexual dysfunction) are involved in male infertility and its related disorders.(3,4) The genetic disorders, including mutations, chromosomal aberrations, polymorphisms and Received: 6 October 2019 Revised: 4 December 2019 Ac…”
Background
The Key Role of Zinc in Enhancement of Total Antioxidant Levels in Spermatozoa of Patients with Asthenozoospermia
Hadwan, M. H., Almashhedy, L. A., & Alsalman, A. R. S. (2012) · American journal of molecular and cellular biology · doi:10.7726/ajmcb.2013.1004 · Cited by 13
“Seminal TAC has been shown to be related to male infertility (Agarwal et al., 2006), therefore, it is important to precisely estimate the total antioxidant amount of the seminal plasma.”
Background
The Role of Seminal Oxidative Stress in Recurrent Pregnancy Loss
Davies, R., Jayasena, C. N., Rai, R., & Minhas, S. (2023) · Antioxidants · doi:10.3390/antiox12030723 · Cited by 12
“exposures [17,29–35] (Figure 1) Furthermore, several studies have shown an association between varicoceles and increased ROS [36].”
Background
In Silico Sperm Proteome Analysis to Investigate DNA Repair Mechanisms in Varicocele Patients
Finelli, R., Darbandi, S., Pushparaj, P. N., Henkel, R., Ko, E. Y., & Agarwal, A. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.757592 · Cited by 11
Self-citation
Effect of varicocele repair on sperm retrieval rate and testicular histopathological patterns in men with nonobstructive azoospermia
Birowo, P., Prasetyo, D. T., Pujianto, D., Atmoko, W., Rasyid, N., & Sini, I. R. (2021) · Asian Journal of Andrology · doi:10.4103/aja.aja_29_21 · Cited by 11
Current markers for infertility in men
Magalhães, J. A., Ribeiro, L. S., Rêgo, J., & de Andrade, C. R. (2020) · JBRA Assisted Reproduction · doi:10.5935/1518-0557.20210013 · Cited by 11
“Reactive oxygen species (ROS) are important for the physiology, capacity and function of sperm development (Ammar et al., 2019; Agarwal et al., 2006).”
Background
The Role of Obesity in ROS Generation and Male Infertility
Kashou, A. H., du Plessis, S. S., & Agarwal, A. K. (2012) · Humana Press eBooks · doi:10.1007/978-1-61779-776-7_26 · Cited by 11
“Higher grades of varicocele in men have shown elevated levels of ROS in their semen, serving as biomarkers of OS from ROS-induced LPO and DNA damage, both of which decrease semen function and contribute to male infertility [ 61, 62 ] .”
BackgroundSelf-citation
Is Varicocelectomy Useful for Subfertile Men with Isolated Teratozoospermia?
Choe, J. H., & Seo, J. T. (2015) · Urology · doi:10.1016/j.urology.2015.08.014 · Cited by 11
“There is evidence to suggest that varicocelectomy results in improvements in other measures of sperm quality not captured with standard semen testing, such as seminal reactive oxygen species levels and DNA Fragmentation Index measurements.(23,24) Abnormal sperm forms may serve more as a barrier to reaching and penetra…”
Background
Oxidative Stress, Sperm DNA Fragmentation, or Both? Optimizing Test Selection in Male Infertility Evaluation
Kaltsas, A., Papaharitou, S., Sengupta, P., Saleh, R., & Agarwal, A. (2026) · Antioxidants · doi:10.3390/antiox15030293 · Cited by 11
“Markedly increased ROS or an abnormal ORP supports a diagnosis of varicocele-related oxidative injury [151].”
Self-citation
Toxoplasma gondii induced sperm DNA damage on the experimentally infected rats
Taherimoghaddam, M., Bahmanzadeh, M., Maghsood, A., Fallah, M., Tapak, L., & Foroughi-Parvar, F. (2020) · Journal of Parasitic Diseases · doi:10.1007/s12639-020-01305-6 · Cited by 10
Zeta and hyaluronic acid assessments, novel sperm selection procedures, in animal model for male infertility
Rezaei-Agdam, H., Moshari, S., Nahari, E., Minas, A., Daliri, Z., Hallaj, M., & Razi, M. (2019) · Andrologia · doi:10.1111/and.13447 · Cited by 10
The protective effect of coenzyme Q10 and berberine on sperm parameters, with and without varicocelectomy in rats with surgically induced varicoceles
Najaran, H., Rashtbari, H., Mohammadi, A., Soleimanifar, F., Izadpanah, F., Kashani, H. H., & Bafrani, H. H. (2018) · Comparative Clinical Pathology · doi:10.1007/s00580-018-2850-y · Cited by 10
Comparison of Before and After Varicocelectomy Levels of Nitric Oxide in Seminal Fluid of Infertile Men
Keyhan, H., Dadvar, A., Ansari, M., & Rafiee, K. (2012) · Nephro-Urology Monthly · doi:10.5812/numonthly.4696 · Cited by 10
“Low concentrations of exogenous NO donors have been shown to enhance; human sperm motility, viability, capacitation, and binding to the zona pellucida (14-16).”
Sperm DNA Fragmentation in Men with Varicocele: A Systematic Review and Meta-Analysis
Palani, A., Çayan, S., Cannarella, R., Saleh, R. A., Altay, B., Kadıhasanoğlu, M., Harraz, ‬. M., Dimitriadis, F., Ceyhan, E., Rezano, A., et al. (2025) · The World Journal of Men s Health · doi:10.5534/wjmh.250025 · Cited by 7
“The varicocele grade is correlated with OS severity, with higher grades associated with increased oxidative damage [2,3].”
Self-citation
The effect of astaxanthin after varicocele surgery on antioxidant status and semen quality in infertile men: A triple‐blind randomized clinical trial
Salih, S. A. M., Jabarpour, M., Gilani, M. A. S., Sajadi, H., Marghmaleki, M. S., Nashtaei, M. S., Salem, M., & Amidi, F. (2024) · Food Science & Nutrition · doi:10.1002/fsn3.4365 · Cited by 9
“Similarly, it has been observed that ASX has a protective effect on intestinal tissue by reducing the levels of ROS and OSI while increasing the levels of TAC (Akduman et al., 2021 ). prior research validated that ASX supplementation for 60 days increased the follicular fluid (FF) level of TAC, whereas the FF levels o…”
ResultInfluential
Investigation of sperm hsa-mir-145-5p and MLH1 expressions, seminal oxidative stress and sperm DNA fragmentation in varicocele
Hekim, N., Gunes, S. O., Ergün, S., Alkan, E. N., & Aşçı, R. (2024) · Molecular Biology Reports · doi:10.1007/s11033-024-09534-1 · Cited by 9
“Studies have shown that, in line with the results of this study, the seminal antioxidant levels of infertile men with varicocele are considerably lower than in fertile individuals without varicocele [42, 43].”
Oxidative Stress and Cell Cycle Arrest in Seminiferous Tubules Nearby Varicose Vessels: New Perspectives from Experimental Varicocele
Minas, A., Razi, M., Nasr‐Esfahani, M. H., Hashemi‐Asl, S. M., & Tavalaee, M. (2023) · Reproductive Sciences · doi:10.1007/s43032-023-01200-4 · Cited by 9
Sperm Heterogeneity Accounts for Sperm DNA Methylation Variations Observed in the Caput Epididymis, Independently From DNMT/TET Activities
Chen, H., Scott-Boyer, M., Droit, A., Robert, C., & Belleannée, C. (2022) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2022.834519 · Cited by 9
“Considering that the ATP synthase component Atp5g1 participates in the control of oxidative phosphorylation and that sperm methylation is susceptible to the presence of reactive oxygen species (ROS) (Agarwal et al., 2006; Tunc and Tremellen, 2009), it is possible that a subpopulation of spermatozoa possessing a higher…”
Background
Dietary supplements in the management of varicocele‐induced infertility: A review of potential mechanisms
Arab, D., Doustmohammadi, H., & Zadeh, A. A. (2020) · Andrologia · doi:10.1111/and.13879 · Cited by 12
“These theories are associated with tissue hypoxia (testicular ischaemia) and oxidative stress (Agarwal et al., 2006), degenerative alteration in the seminiferous tubules (Liu et al., 2014), elevated apoptosis among developing germ cells (cause of oligospermia) (Marmar, 2001) and sperm DNA damage…”
Background
Specific activity of Korean red ginseng saponin and non-saponin fractions in ageing-induced rat testicular dysfunction
Kopalli, S., Cha, K.-M., Ryu, J., Hwang, S.-Y., & Kim, S.-K. (2017) · doi:10.1016/j.jff.2016.12.031 · Cited by 9
Effect of spermatic vein ligation on seminal total antioxidant capacity in terms of varicocele grading
Ozturk, U., Özdemi̇r, E., Buyukkagnıcı, U., Dede, O., Sucak, A., Celen, S., & İmamoğlu, M. A. (2012) · Andrologia · doi:10.1111/j.1439-0272.2011.01164.x · Cited by 9
“Because seminal plasma has an antioxidant mechanism, total seminal plasma antioxidants is the most important defensive mechanism protecting spermatozoa against ROS (Said et al., 2003; Agarwal et al., 2006).”
Background
Light and electron microscopic study of the effect of L-carnitine on the sperm morphology among sub fertile men
El-baset, S. A. A., El-Wahab, S. M. A., Mansour, A., & Mohamed, E. A. H. (2010) · doi:10.1016/j.mefs.2010.04.005 · Cited by 9
Therapeutic Effects of Xianlu Oral Solution on Rats with Oligoasthenozoospermia through Alleviating Apoptosis and Oxidative Stress
Jin, Z.-R., Cao, Y., Luo, Z.-C., Zhao, Q.-C., Xi, Y., Weng, J., Zhang, Z., & Jiang, H. (2022) · Evidence-Based Complementary and Alternative Medicine · doi:10.1155/2022/1269530 · Cited by 8
OXIDATIVE STRESS AND MALE FERTILITY: MODERN VIEW ON THE PROBLEM
Kirilenko, E., & Onopko, V. (2017) · doi:10.12737/article_59a614fd84d146.40261567 · Cited by 8
“С увеличением синтеза СР при варикоцеле происходит нарушение целостности ДНК сперматозоида [21].”
Re: Attenuation of oxidative stress after varicocelectomy in subfertile patients with varicocele. S. S. Chen, W. J. Huang, L. S. Chang and Y. H. Wei. J Urol 2008; 179: 639-642.
Verit, A. (2008) · Journal of Urology · doi:10.1016/j.juro.2008.05.058 · Cited by 8
Oxidative Stress in Unexplained Male Infertility
Doshi, S., Sharma, R., & Agarwal, A. (2015) · doi:10.1007/978-1-4939-2140-9_10 · Cited by 8
“In regard to the male reproductive system, low ROS levels are necessary for capacitation, hyperactivation, acrosome reaction, zona pellucida binding and fertilization capacity of spermatozoa and promote normal semen parameters, such as sperm motility, morphology, and viability [19, 28, 46].”
BackgroundSelf-citation
Clinical Consequences of Oxidative Stress in Male Infertility
Said, T., Gokul, S., & Agarwal, A. (2012) · Humana Press eBooks · doi:10.1007/978-1-61779-776-7_24 · Cited by 8
Self-citation
Circular Economy, Dairy Cow Feed Leftovers, and Withania somnifera Supplementation: Effects on Black Belly Ram’s Libido, Sperm Quality, Sexual Behavior, and Hemogram Values
Rodriguez-Sánchez, A. J., Meza-Herrera, C., Santiago-Miramontes, Á. D., Navarrete-Molina, C., Véliz-Deras, F., Ordoñez-Morales, J., Flores-Salas, J. M., & Marín-Tinoco, R. I. (2024) · Biology · doi:10.3390/biology13090656 · Cited by 7
“Indeed, these two cell lines are expressly prone to subcellular changes generated by an augmented metabolic rate and, in turn, the release of reactive oxygen species (ROS) [31,32].”
Background
Male factor infertility: A contemporary overview of investigation, diagnosis and management
Krishan, A., Vukina, J., Pearce, I., & Modgil, V. (2022) · Journal of Clinical Urology · doi:10.1177/20514158221078474 · Cited by 5
“43 Testicular biopsy.”
Effect of Filgrastim on adult male rats’ fertility and reproductive performance
Saber, S., Alduweesh, N. B., El-Rahman, H. A. A., & Omar, A. (2021) · Saudi Journal of Biological Sciences · doi:10.1016/j.sjbs.2021.01.060 · Cited by 6
“Thus, the seminal ROS level can be used as an indicator for male infertility (Agarwal et al., 2006; Muratoğlu et al., 2018).”
Background
Epidemiology of Oxidative Stress in Male Fertility
Owyong, M., & Ramasamy, R. (2019) · Oxidants, Antioxidants and Impact of the Oxidative Status in Male Reproduction · doi:10.1016/b978-0-12-812501-4.00009-2 · Cited by 6
Is It Time for Andrology and Endocrinology Professionals in Assisted Reproduction Centers?
Cannarella, R., Marino, M., Condorelli, R., Vignera, S. L., & Calogero, A. (2023) · The World Journal of Men's Health · doi:10.5534/wjmh.220253 · Cited by 5
“…and impaired sperm parameters who had undergone surgical correction, showed an increase in sperm concentration and motility, thus concluding that surgical correction of varicocele considerably raises semen parameters in infertile men with palpable varicocele and abnormal seminal fluid [45].”
Evaluation of sialic acid, malondialdehyde and glutathione levels in infertile male
Menevşe, E., Dursunoğlu, D., Cetin, N., Korucu, E. N., & Erbayram, F. Z. (2022) · Revista Internacional de Andrología · doi:10.1016/j.androl.2021.05.002 · Cited by 6
The use of DNA semen fragmentation in andrological practice
Авадиева, Н. Э. (2019) · Urology Herald · doi:10.21886/2308-6424-2019-7-1-7-11 · Cited by 8
Association of Seminal Plasma Total Antioxidant Capacity and Malondialdehyde Levels With Sperm Parameters in Infertile Men With Varicocele
Salimi, S., Fazeli, F., Khosravi, P., & Nabizadeh, S. (2016) · doi:10.17795/ajmb.33540 · Cited by 5
“higher ROS and lower total antioxidant capacity levels in the varicocele population compared to fertile men have been shown (30).”
Background
Herbal medicine used to treat andrological problems: Asia and Indian subcontinent: Withania somnifera, Panax ginseng, Centella asiatica
Sengupta, P., Durairajanayagam, D., & Agarwal, A. K. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-815565-3.00015-1 · Cited by 4
Self-citation
Increased Oxidative DNA Damage in Seminal Plasma of Infertile Men with
Wang, Q.-L., Tang, L.-X., Deng, S.-M., Tang, Y.-G., & Zheng, L.-X. (2014) · doi:10.4172/2167-0250.1000119 · Cited by 5
“Studies included in the meta-analysis demonstrated a strong correlation between semen parameters and ROS concentrations [25].”
Background
Is there a real risk of transmitting variant Creutzfeldt-Jakob disease by donor sperm insemination?
Mortimer, D., & Barratt, C. L. R. (2006) · Reproductive BioMedicine Online · doi:10.1016/s1472-6483(10)61024-3 · Cited by 7
A systematic review on the role of paternal factors in human placental development, function, and pregnancy-related disorders
Johnson, J., Nair, S., Singh, D., Balasinor, N., & Nishi, K. (2025) · Journal of Assisted Reproduction and Genetics · doi:10.1007/s10815-025-03594-3 · Cited by 3
“A significant reduction in the seminal antioxidant capacity in men suffering from varicocele has been reported [74] which affects the fluidity of plasma membrane and DNA integrity in spermatozoa [131].”
Molecular Remodeling of the Sperm Proteome Following Varicocele Sclero-Embolization: Implications for Semen Quality Improvement
Milardi, D., Vergani, E., Mancini, F., Nicuolo, F. D., Teveroni, E., Vodola, E., Oliva, A., Grande, G., Cina, A., Iezzi, R., et al. (2025) · Proteomes · doi:10.3390/proteomes13030034 · Cited by 3
“Furthermore, increased oxidative stress has been described [27].”
Mapping the Scientometric Landscape of Andrology: Trends, Gaps, and Future Directions in Male Reproductive Health: A Scoping Review
Mahmutoglu, A. M., Agarwal, A. K., Alipour, H., Pinggera, G., Khalafalla, K. M., Şahin, B., Pescatori, E., Piryaei, F., Hashimi, M. A., & Shah, R. S. (2025) · The World Journal of Men s Health · doi:10.5534/wjmh.250006 · Cited by 1
“Many reviews and/or meta-analysis studies have been conducted and published on OS and male infertil-Fig www.wjmh.org ity over the years [44-48].”
Self-citation
A Key regulatory protein QRICH2 governing sperm function with profound antioxidant properties, enhancing sperm viability.
Zhang, G.-H., Xiong, D.-S., Ye, F., Zhao, Y.-H., Du, X.-R., Zhi, W.-W., Liu, F., Zeng, J., Xu, W.-M., Liu, W.-X., et al. (2024) · Reproductive Biology · doi:10.1016/j.repbio.2024.100881 · Cited by 3
SUMO1 and Defective Spermatozoa Correlate with Endogenous Hydrogen Peroxide and Live Birth Outcome in Intrauterine Insemination Cycles for Unexplained Infertility
Huang, M., Tzeng, S., Chen, W.-J., Chen, S., Ding, Y.-R., Lee, C., Lee, M., & Lee, T. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms241612775 · Cited by 3
Evaluation of free light chains of immunoglobulins in normal and pathological seminal fluids: Preliminary data
Basile, U., Vergani, E., Napodano, C., Bruno, C., Marino, M., Oliva, A., Gulli, F., & Mancini, A. (2021) · Andrologia · doi:10.1111/and.14317 · Cited by 3
“…is lower in VAR, even when associated with inflammation (VAR/INF group), suggesting a possible different trigger for B- cell activation, rather than inflammation, or a higher consumption in turn related to the peculiar biochemical environment of VAR (Agarwal et al., 2006; Mancini et al., 2012).”
BackgroundInfluential
[Favorable impact of left antegrade sclerotherapy of clinical left varicocele on spermogram].
Bonnet, Q., Coppens, L., Delvigne, A., & Waltregny, D. (2020) · Progrès en urologie (Paris) · doi:10.1016/j.purol.2020.02.010 · Cited by 3
“[5] Agarwal A, Prabakaran S, Allamaneni SS.”
Traitement radiologique endovasculaire des varicocèles
Tassart, M., Khalil, A., & Boudghène, F. (2014) · EMC - Radiologie et imagerie médicale - Génito-urinaire - Gynéco-obstétricale - Mammaire · doi:10.1016/s1879-8543(14)58175-x · Cited by 3
Practical Urological Ultrasound
Fulgham, P., & Gilbert, B. (2021) · doi:10.1007/978-3-030-52309-1 · Cited by 3
Reactive Oxygen and Nitrogen Species in Male Reproductive Health: From Molecular Mechanisms to Clinical Consequences
Wang, S., Chung, J. P., & Chan, D. Y. L. (2026) · Antioxidants · doi:10.3390/antiox15070795 · Cited by 2
“Increased levels of oxidative stress markers, including malondialdehyde and nitric oxide, alongside reduced nonenzymatic and enzymatic antioxidant defenses, reflect a disrupted redox balance [161,162].”
Sudachitin Alleviates Paraquat Instigated Testicular Toxicity in Albino Rats via Regulating Nrf‐2/Keap‐1, Inflammatory, Steroidogenic, and Histological Profile
Ijaz, M. U., Imtiaz, S., Hayat, M. F., Batool, M., Al‐Ghanim, K. A., & Riaz, M. N. (2024) · Environmental Toxicology · doi:10.1002/tox.24408 · Cited by 2
“Sperms cells are vulnerable to ROS owing to the presence of unsaturated fatty acids in their plasma membranes [52].”
Ten-year outcomes of patients who developed persistent azoospermia following chemotherapy associated with different oncological diagnoses: A retrospective cohort study from a different perspective
Şalvarcı, A., Gürbüz, A. S., & Balasar, M. (2022) · Turkish Journal of Medical Sciences · doi:10.55730/1300-0144.5373 · Cited by 2
Biochemical and Histological Evaluation of Protective Effect of Betaine in Experimental Varicocele Using Animal Model
Asadi, N., Kheradmand, A., & Gholami, M. (2018) · International Journal of Peptide Research and Therapeutics · doi:10.1007/s10989-018-9718-5 · Cited by 2
“higher ROS and lower total antioxidant capacity levels in the varicocele population compared to fertile men have been shown (Agarwal et al. 2006).”
Background
Compendium of Oxidative Stress-Related Research from Cleveland Clinic (1993–2016)
Durairajanayagam, D., Dhillon, A. S., Salasin, R., Kashou, A. H., & Kothandaraman, N. (2017) · Springer eBooks · doi:10.1007/978-3-319-48427-3_8 · Cited by 2
Food deprivation and social inequality may lead to oxidative damage: a study on the preventive role of melatonin in the male rat reproductive system.
Nasiraei-Moghadam, S., Parivar, K., Ahmadiani, A., Movahhedin, M., & Mahdavi, M. (2016) · Reproduction, Fertility and Development · doi:10.1071/rd14432 · Cited by 2
Effects of free radicals on male fertility and available treatment
Bittner, L., Chocholatý, M., Čechová, M., Zima, T., & Grill, R. (2015) · Czech Urology · doi:10.48095/cccu2015002 · Cited by 2
“Varikokéla signifi kantně zvyšuje míru oxidačního stresu varlat a stejně tak byla mataanalýzou dat prokázána i nižší hladina antioxidační enzymatické aktivity postižených varlat (18).”
Apurinic/apyrimidinic endonuclease immunoreactivity in germ cells of experimental varicocele-induced rat testes.
Yoon, S. (2013) · Acta Histochemica · doi:10.1016/j.acthis.2013.04.011 · Cited by 2
Treatment of oxidative stress and male reproductive rehabilitation
Rozhivanov, R., Chernova, M. O., Rozhivanova, E. R., & Yesaulenko, D. I. (2023) · Problemy reproduktsii · doi:10.17116/repro202329061106 · Cited by 2
Transcriptomics and Oxidative Stress in Male Infertility
Gunes, S., & Mahmutoglu, A. M. (2019) · Oxidants, Antioxidants and Impact of the Oxidative Status in Male Reproduction · doi:10.1016/b978-0-12-812501-4.00023-7 · Cited by 2
Varicocele and Male Infertility: Evidence in the Era of AssistedReproductive Technology
Chung, E. (2014) · doi:10.4172/2161-038x.1000e114 · Cited by 2
“Reprod Syst Sex Disord ISSN:2161-038X RSSD, an open access journal Volume 3 • Issue 1 • 1000e114 Male Reproduction & Infertility activity in sperm, and reduced total antioxidant capacity of semen [9].”
Background
Antioxidants and Oxidative Stress in Seminal Fluid and Sperm
Demirtas, A., & Untan, I. (2011) · doi:10.5152/tus.2011.05 · Cited by 2
Varicocele: To Fix or Not to Fix
Pasqualotto, F. F., Borges, E., Roth, F., Lara, L. V., & Pasqualotto, E. B. (2010) · Humana Press eBooks · doi:10.1007/978-1-60761-193-6_8 · Cited by 4
The effect of oxidative stress on male fertility: A review
., I. (2023) · International Journal of Science and Research Archive · doi:10.30574/ijsra.2023.9.2.0683 · Cited by 1
Comparison of Oxidative Stress Intensity in the Seminal Plasma and Serum of Infertile Patients with Different Varicocele Grades and Subjects with No Varicocele: A Cross-Sectional Study
Yousefniapasha, Y., Mahjoub, P. D. S., Gholami, M., Taherkhani, M., Beyki, A., & Gholinezhad, M. (2017) · doi:10.5812/ircmj.13312 · Cited by 1
Introduction to Reactive Oxygen Species: Emphasizing Their Importance in the Male Reproductive System
Skosana, B. T., Oyeyipo, I. P., & du Plessis, S. S. (2016) · CRC Press eBooks · doi:10.1201/b20228-3 · Cited by 1
Olive oil and male fertility
Domínguez-Vías, G., Segarra, A. B., Ramírez‐Sánchez, M., & Prieto, I. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-819528-4.00057-2 · Cited by 1
Improvement of sperm function, chromatin damage, and oxidative damage by N-Acetyl cysteine in varicocelized rats model
Tavalaee, M., Dattilo, M., Mohammadi, P., & Nasr-Esfahani, M. (2020) · doi:10.22037/mhj.v4i1.30440 · Cited by 1
“It is well established that varicocele-associated infertility and ROS-mediated sperm damage are detectable in 30-80% of cases (16).”
Background
Short-term outcome of unaided versus microsurgical inguinal varicocelectomy among infertile men with varicocele
Muhammad, M., Muhammed, A., Bello, A., Lawal, A., Mudi, A., Sudi, A., Oyelowo, N., Tolani, M., Hamza, B., Lovely, F., et al. (2018) · doi:10.4103/ajiac.ajiac_2_19 · Cited by 1
OXIDATIVE STRESS AND SPERM PATHOLOGIES
Evdokimov, V., Zhukov, O., Kastrikin, Y. V., Baizhumanov, A., Turovetskiy, V. B., & Pirutin, S. (2017) · doi:10.17650/2070-9781-2017-18-2-27-32 · Cited by 1
“Эти результаты совпадают с данными, полученными в других работах [18, 21, 22].”
Sperm DNA fragmentation and its impact on pregnancy outcomes: a narrative review focusing on threshold definition and clinical strategies
Cheng, S.-H., Yuan, Y., Wang, Z.-H., Xie, Z.-H., Chen, Q.-X., Liu, Z., Chen, Y., Song, T.-G., Yan, M.-Q., Zheng, Z.-J., et al. (2026) · Translational Andrology and Urology · doi:10.21037/tau-2026-0544
“Its presence leads to venous stasis and oxidative stress, key mediators in the development of SDF and testicular dysfunction (139).”
Oxidative Damage, Antioxidant Capacity, and Apoptotic Activation in Varicocele: Biochemical Evidence of Improvement After Surgical Repair
Orman, E., Uzun, H., Yigit, M. H., Yiğit, E., Zihni, H., & Akça, G. (2026) · Antioxidants · doi:10.3390/antiox15040455
“When antioxidant defense mechanisms are insufficient to neutralize ROS, redox imbalance occurs, leading to lipid peroxidation and oxidative DNA damage [9,10].”
Evaluation of Oxidative Stress and Its Impact on Sperm DNA Fragmentation and Semen Parameters in Infertile Men
Berrada, K., Touhamia, Y., Serbouti, A., Aamiri, A., Ousaid, F. E., Housbane, S., Kabine, M., Louanjli, N., & Aboutaieb, R. (2026) · The Scientific World JOURNAL · doi:10.1155/tswj/8887567
“OS results from an imbalance between excessive production of reactive oxygen species (ROS) and insufficient antioxidant defenses [4, 5].”
Potential of White Oyster Mushroom to Improve Male Fertility : A Systematic Review
Andrianto, Y. F. T., Ardinata, D., & Ichwan, M. (2024) · International Journal of Ecophysiology · doi:10.32734/ijoep.v6i2.17428
“Age over 40 years, uncomfortable work environment, excessive and heavy workload [11], hormonal disorders, physical activity, lifestyle, psychology, sexual problems, chromosomal abnormalities and single gene defects [8], including oxidative stress (SO) [12].”
Background
ROLE OF COLOR DOPPLER ULTRASONOGRAPHIC PARAMETER AS A PREDICTOR OF SPERMATOGENESIS AND INFERTILITY
PATNAIK, P., Trivedi, S. S., & SHAW, D. (2024) · Asian Journal of Pharmaceutical and Clinical Research · doi:10.22159/ajpcr.2024v17i7.51109
“varicocele [9,10]. et al Our findings aligned with the research conducted by Battaglia .”
Result
The Impact of Using Extenders Containing Low-density Lipoprotein Versus Egg Yolk with or without Ascorbic Acid on the Fertility Parameters of Post-thawed Chilled Canine Semen
Elbehiry, M., El-Aziz, A. A. A., Belal, M., & Sobhy, K. (2024) · Damanhour Journal of Veterinary Sciences · doi:10.21608/djvs.2024.266721.1129
“ROS are normally well controlled by natural antioxidants within cells (Agarwal, Prabakaran, & Allamaneni, 2006).”
Background
DNA Damage in Spermatozoa
Hayden, R., Aboukhshaba, A., & Schlegel, P. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108762571.017
Assessment of the Impact of Oxidative Stress on Frozen Seminal Plasma in Fertile and Infertile Men by Examining the Total Antioxidant Capacity
Rilcheva, V., Ayvazova, N., Martinov, D., Ivanov, C. И., & Konova, E. (2014) · doi:10.1515/jbcr-2015-0121
“Other factors such as nutrition, vitamin supply, age, and infection have been reported to influence antioxidant capacity may be influenced by the factors such as [20, 17].”
Seminal Plasma Soluble forms of Fas, Oxidants and Antioxidants in Infertile Men with Varicocele
Tawadrous, G., Mostafa, T., & Aziz, A. (2012) · doi:10.21608/besps.2012.35825

Authors: Agarwal, A., Prabakaran, S., & Allamaneni, S. S.
Affiliations: Glickman Urological Institute (US)
ORCID: Agarwal, Ashok
Allamaneni, Shyam SSR
Venue: Reproductive BioMedicine Online
Publisher: Elsevier BV
Published: 2006-01
Volume: 12
Issue: 5
Pages: 630-633
ISSN: 1472-6483 (ISSN-L)
DOI: 10.1016/s1472-6483(10)61190-x
OpenAlex: W2169474580
Cited by: 261
References: 20
Citations by year: 2026: 7 · 2025: 10 · 2024: 15 · 2023: 20 · 2022: 22 · 2021: 20 · 2020: 19 · 2019: 11 · 2018: 9 · 2017: 17 · 2016: 9 · 2015: 18 · 2014: 8 · 2013: 13 · 2012: 18
FWCI: 10.48
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Reproductive BioMedicine Online (publishedVersion)
PubMed (publishedVersion)
Funders: Cleveland Clinic
Topics: Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
Health Sciences › Medicine › Urology › Male Reproductive Health Studies
Health Sciences › Medicine › Biochemistry (medical) › Antioxidant Activity and Oxidative Stress
Keywords: varicocele, male infertility, oxidative stress, reactive oxygen species, sperm dysfunction, total antioxidant capacity, antioxidant status
MeSH terms: Antioxidants, Humans, Infertility, Male, Male, Spermatozoa, Varicocele, Reactive Oxygen Species, Oxidative Stress

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Relationship between oxidative stress, varicocele and infertility: a meta-analysis

Abstract

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Self-check

Citations

Cites

Cited by

Metadata

Record

About these checks