The excessive use of antioxidant therapy: a possible cause of male infertility?
Abstract
Reactive oxygen species and oxidative stress are closely associated with various pathologies such as neurodegenerative diseases, ageing and male infertility. Hence, antioxidants such as vitamin C, vitamin E, N-acetyl cysteine, L-carnitine and folic acid are regularly used in various treatment regimens to protect cells from the damage induced by free radicals. However, given their over-the-counter availability at unnaturally high concentrations and also the fact that they are commonly added to various food products, patients may run a risk of consuming excessive dosages of these compounds, which may then be toxic. The few studies that have assessed antioxidant overuse and the associated adverse effects found that large doses of dietary antioxidant supplements have varying-if any-therapeutic effects even though free radicals clearly damage cells-a phenomenon that has been termed the "antioxidant paradox." Furthermore, overuse of antioxidants such as vitamin C, vitamin E, N-acetyl cysteine may lead to reductive stress, which is reported to be as dangerous to cells as oxidative stress and can be the cause of diseases such as cancer or cardiomyopathy. Therefore, we feel that there is a need for more elaborate research to establish the clear benefits and risks involved in antioxidant therapy for male infertility.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
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?
Similar to the MOXI trial, the high quality trials included in the Cochrane review did not find a benefit to antioxidants on live birth.
“Similar to the MOXI trial, the high quality trials included in the Cochrane review did not find a benefit to antioxidants on live birth. (25, 26)”
From The effect of antioxidants on male factor infertility: the Males, Antioxidants, and Infertility (MOXI) randomized clinical trial (2020) · cites this paper as [26]
Cites
Mitochondrial formation of reactive oxygen species
Turrens, J. F. (2003) · The Journal of Physiology · doi:10.1113/jphysiol.2003.049478 · Cited by 5,084 · see citing works
Mitochondria, oxygen free radicals, disease and ageing
Raha, S., & Robinson, B. H. (2000) · Trends in Biochemical Sciences · doi:10.1016/s0968-0004(00)01674-1 · Cited by 1,066 · see citing works
Rajasekaran, N. S., Connell, P., Christians, E. S., Yan, L.-J., Taylor, R. P., Orosz, A., Zhang, X. Q., Stevenson, T. J., Peshock, R. M., Leopold, J. A., et al. (2007) · Cell · doi:10.1016/j.cell.2007.06.044 · Cited by 437 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Steiner, A. Z., Hansen, K. R., Barnhart, K. T., Cedars, M. I., Legro, R. S., Diamond, M. P., Krawetz, S. A., Usadi, R., Baker, V. L., Coward, R. M., et al. (2020) · Fertility and Sterility · doi:10.1016/j.fertnstert.2019.11.008 · Cited by 213 · see citing works
- Authors
- Henkel, R., Sandhu, I. S., & Agarwal, A.
- Affiliations
- University of the Western Cape (ZA)
- American Centre for Reproductive Medicine; Cleveland Clinic; Cleveland Ohio
- Cleveland Clinic (US)
- Corresponding author
- Henkel, Ralf
- Venue
- Andrologia
- Publisher
- Wiley
- Published
- 2018-09-26
- Volume
- 51
- Issue
- 1
- Pages
- e13162
- ISSN
- 0303-4569 (ISSN-L)
- OpenAlex
- W2893885083
- Cited by
- 169
- References
- 3
- Citations by year
- 2026: 9 · 2025: 15 · 2024: 27 · 2023: 19 · 2022: 28 · 2021: 34 · 2020: 29 · 2019: 7 · 2018: 1
- FWCI
- 2.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Andrologia (publishedVersion)
- PubMed (publishedVersion)
- UWC Research Repository (University of the Western Cape) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
- Health Sciences › Medicine › Biochemistry › Antioxidant Activity and Oxidative Stress
- Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
- Keywords
- male infertility, oxidative stress, reactive oxygen species, vitamin C, vitamin E, N-acetylcysteine, L-carnitine, folic acid, antioxidant toxicity, reductive stress, supplement safety
- MeSH terms
- Antioxidants, Humans, Infertility, Male, Male, 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