The pathophysiology of male infertility involves various interlinked endogenous pathways. About 50% of the cases of infertility in men are idiopathic, and oxidative stress (OS) reportedly serves as a central mechanism in impairing male fertility parameters. The endogenous antioxidant system operates to conserve the seminal redox homeostasis required for normal male reproduction. OS strikes when a generation of seminal reactive oxygen species (ROS) overwhelms endogenous antioxidant capacity. Thus, antioxidant treatment finds remarkable relevance in the case of idiopathic male infertility or subfertility. However, due to lack of proper detection of OS in male infertility, use of antioxidant(s) in some cases may be arbitrary or lead to overuse and induction of 'reductive stress'. Moreover, inflammation is closely linked to OS and may establish a vicious loop that is capable of disruption to male reproductive tissues. The result is exaggeration of cellular damage and disruption of male reproductive tissues. Therefore, limitations of antioxidant therapy in treating male infertility are the failure in the selection of specific treatments targeting inflammation and OS simultaneously, two of the core mechanisms of male infertility. The present review aims to elucidate the antioxidant paradox in male infertility treatment, from the viewpoints of both induction of reductive stress as well as overlooking the inflammatory consequences.

Department of Animal Morphology Physiology and Genetics Faculty of AgriSciences Mendel University in Brno Zemedelska 1 61300 Brno Czech Republic

Department of Life Science and Bioinformatics Assam University Silchar 788011 India

Department of Oral Biology and Biomedical Sciences Faculty of Dentistry MAHSA University SP2 Bandar Saujana Putra Jenjarom 42610 Selangor Malaysia

Physiology Unit Faculty of Medicine Bioscience and Nursing MAHSA University SP2 Bandar Saujana Putra Jenjarom 42610 Selangor Malaysia

School of Medical Sciences Bharath Institute of Higher Education and Research 173 Agaram Main Rd Selaiyur Chennai 600073 India

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