The Role of Antioxidants in Male Fertility: A Comprehensive Review of Mechanisms and Clinical Applications

Abstract

Oxidative stress is a significant factor in male infertility, with increasing evidence evaluating the role of antioxidants in mitigating its detrimental effects on sperm function and quality. This review examines the mechanisms by which reactive oxygen species (ROS) impact male reproductive health. This article synthesizes the different mechanisms at play and highlights key clinical studies published in the literature that contribute to our understanding of antioxidants to treat male infertility. These studies suggest that supplementation with specific antioxidants may improve sperm parameters and increase fertility outcomes, although results vary depending on dosage, duration, and individual health conditions. Despite promising findings, there are inconsistencies across study methodologies and a lack of standardized treatment protocols, which underscore the need for more rigorous clinical trials. Antioxidant supplementation has the potential to serve as a supportive treatment for male infertility, but it should be approached cautiously and appropriately by carefully selecting patients who are deficient in the administered antioxidants. There is a need to better evaluate the long-term impact on reproductive outcomes and determine the optimal supplementation strategies and patient profiles that would benefit most from supplementation regimens.

Keywords: antioxidants; male infertility; oxidative stress.

Figure 1

Sources of oxidative stress and antioxidant defense systems in male fertility. Reproduced with permission from Ben Khalifa, Nutrients; published by MDPI 2025 [12].

Figure 2

The mechanisms involved in ROS production within spermatozoa. Reproduced with permission from Ben Khalifa, Nutrients; published by MDPI 2025 [12].