A recent study from the Cleveland Clinic found that Reactive Oxygen Species (ROS) were 7 fold higher in 54 men with male factor infertility versus 51 men with normal sperm. ROS are highly reactive, free radical chemicals (consisting of one or more unpaired electrons). They are made by sperm as part of normal function, but can also be made by white blood cells or abnormal sperm in higher, damaging levels, which if present cause “ oxidative stress”. Most of us think about free radical or oxidative stress regarding aging of our faces and concerns with how we look as we age.
However, oxidative stress is a big problem for sperm as it can cause damage to the sperm’s ability to swim, its normal shape and most importantly to the sperm DNA or genetic material. All of these changes can impact fertility and pregnancy outcomes. Several factors can increase ROS in semen including smoking, varicoceles, and genital tract infection. Some studies suggest that low grade genital tract infections are very under diagnosed in men, and I happen to agree with this.
Normal men have fairly high levels of antioxidants in their semen to keep ROS and oxidative stress at the right levels. However, between 25 and 88% of infertile men (study dependant) have elevated ROS in their semen, which can lead to loss in ability to swim (motility), loss of normal shapes (changes in morphology) and breakage in the DNA structure (leading to fertilization failure, pregnancy losses, and even childhood diseases).
The new study by Desai et al., (Fert &Ster Nov 2009) found that the level of ROS in a semen sample could be used to predict over 75% of the infertile men, with ROS levels being much, much higher for these men than for the men with normal sperm parameters.
Why is this important? Because having ROS measured in sperm samples from couples with infertility could: a) help identify if there is a male factor involved in the infertility and b) help identify men for whom further diagnostics and therapies may be helpful. These would include, low grade infections which may need special antibiotics, such as men with ureaplasma or mycoplasma infections. Also, identifying men with high ROS could increase compliance with antioxidant vitamin therapy, such as those found in fertility supplements (e.g. FertilAid).
In general, couples planning on assisted reproduction may be able to improve outcomes by decreasing semen ROS values prior to treatment. Of course, those trying naturally could also benefit from lowered oxidative stress. I suggest anyone who is TTC at least try fertility vitamins with antioxidants for 6 months.
To have an ROS assay done, couples in the Northwest could contact Dr. Muller at University of Washington. The Cleveland Clinic can also perform this assay, as well as other referral clinics with an andrologist on board.
For our part, we know that minimizing sperm ROS damage is important. The bioactive plant sugar, arabinogalactan, became part of Pre-Seed’s patented formula after finding that it decreased sperm ROS production. This protective effect on sperm, echoes a larger body of literature which has found an antioxidant effect of arabinogalactan on many other cell types as well.
Hope your New Year is going well!
Blessings-
Dr. E
