Abstract
Abstract Background: Oxidative stress (OS) is a hazardous process that can damage and deform sperm, leading to male infertility. This process occurs when the generation of free radicals from reactive oxygen species (ROS) surpasses the total antioxidant activity in semen. Since seminal plasma creates the environment for the proper functioning of spermatozoa, many substances secreted by male accessory glands (MAGs) have a role in sperm physiology. Thus, a change in the biochemical composition of the seminal plasma could be directly related to infertility. Aim: This study aimed to investigate the association of OS with secretion of the prostate, seminal vesicles, and epididymis in infertile Libyan men. Materials and methods: This study included 79 infertile men and 25 fertile men, and the samples were collected from the fertility lab of the Yashfeen clinic and the Al Shark Lab in Tripoli, Libya. Firstly, a basic semen analysis was performed according to WHO (2021) guidelines, and then ROS levels in semen were measured using the Nitroblue tetrazolium (NBT) method. Subsequently, the performance of MAGs was assessed by selecting one biomarker for each gland, such as citric acid (prostate), fructose (seminal vesicles), and neutral α-glucosidase (NAG) (epididymis). Finally, statistical analysis was performed using the nonparametric Mann-Whitney U test to compare the two study groups and the Spearman correlation coefficient to determine the association between two separate variables. Results: The results showed a decrease in both levels of citric acid (mg/mL) and NAG (mIU/mL) in infertile men compared to fertile men (P <0.001), while the fructose levels remained convergent in both study groups (P >0.05). In contrast, infertile men had significantly higher seminal ROS levels than fertile men (p <0.001). Citric acid, fructose, and NAG levels were positively correlated with semen volume and progressive motility. There were also positive associations among citric acid, NAG, sperm concentration, and normal morphology, as well as between total sperm count and total motility with NAG and citric acid, respectively. In addition, a significant negative correlation was found between seminal ROS levels and all normal sperm parameters, including sperm concentration, total sperm count, vitality, motility, progressive motility, and normal morphology. Besides, seminal ROS levels were negatively associated with citric acid levels and NAG activity. However, no correlation between seminal ROS levels and fructose levels was detected. Conclusion: This study provided new and specific insights into understanding the potential influence of OS on semen quality and secretion of the epididymis and prostate. Therefore, the evaluation of seminal ROS in conjunction with careful evaluation of the secretory products of MAGs may contribute to an accurate diagnosis of the pathophysiology of male infertility and, thus, the determination of appropriate therapy. Keywords: Oxidative stress (OS), Infertile men, Reactive oxygen species (ROS), Male accessory glands (MAGs)