Differential significance of Seminal Cell-Free DNA Levels, Oxidative Stress, and Sperm Characteristic between Infertile Men with Non-obstructive and obstructive Azoospermia.

Objective: The levels of cfDNA in the semen samples of infertile men and its relationship with the level of oxidative stress, antioxidant capacity and lipid peroxidation were investigated.

Methods: Total 100 semen samples were obtained from infertile men with abnormal sperm parameters (oligoasthenospermia (n=10), oligoteratozoospermia (n=10), oligoasthenoteratozoospermia (n=10), and non-obstructive azoospermia (n=50)) and normozoospermic men. cfDNA was extracted and quantified by qPCR. Different markers related to the oxidant and antioxidant status as well as oxidative stress were measured in the seminal plasma samples of the study groups.

Results: cfDNAs content in the oligoasthenoteratozoospermia group was significantly higher than those in the controls. A significant decrease in cfDNAs was observed in the azoospermia group compared to the controls. There was a significant increase in malondialdehyde and other oxidant related markers in all patient groups rather than the normal individuals. In contrast, seminal plasma samples of all patients with abnormal semen parameters showed a significant reduction in the levels of factors associated with antioxidant capacity compared to the controls.

Conclusions: This study highlights the direct link between elevated cfDNA levels, oxidative stress, and impaired sperm parameters in men with azoospermia and oligospermia. Current data underscore the potential competence of cfDNA and oxidative stress as diagnostic tools to classify the severity of male infertility and abnormalities related to semen parameters. Our findings emphasize the importance of antioxidant therapy as an efficient strategy to reduce oxidative damage, enhance sperm quality, and improve reproductive outcomes for male partners of couples with infertility.