Reductive stress and the role of antioxidants in male infertility: a narrative review.

Background: The ability of antioxidant therapy to mitigate oxidative stress (OS)-induced sperm function impairment makes it a popular treatment for male infertility. Reductive stress (RS), a condition characterized by an overcompensation in redox balance that favors reduction over oxidation, may be brought on by excessive or extended antioxidant use, according to mounting evidence. The purpose of this review is to examine the processes by which an excess of antioxidants causes RS and to evaluate any potential negative impacts on men's reproductive health.

Methods: A comprehensive overview of recent clinical and experimental studies focused on the effects of excessive antioxidant use on redox biology, mitochondrial function, spermatogenesis, and sperm quality.

Results: RS has been shown to affect sperm growth and function, interfere with cellular signaling, and damage mitochondrial integrity. Antioxidants are commonly employed, although there are currently no clear clinical guidelines or biomarkers for diagnosis to monitor redox equilibrium.

Conclusions: In male infertility treatments based on antioxidants, RS poses a paradoxical risk. A personalized, balanced approach to antioxidant therapy is essential, alongside the development of biomarkers and standardized protocols to ensure redox homeostasis and avoid potential harm.