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Role of oxidative stress on male infertility PowerPoint Presentation

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Description : Oxidative stress is a current idiopathic case for so many pathological conditions from infertility in both male and female to cancer and other body cell to organ damage. It's early diagnosis can help greatly minimise the rising deleterious effect of these reactive oxygen species.

Tags : Oncology,oxidative stress,Role of oxidative stress,stress,male infertility,infertility

Published on : Mar 08, 2023 | Views : 644 | Downloads : 1

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1 ROLE OF OXIDATIVE STRESS ON MALE INFERTILY BY ORJI CHIBUEZE FAVOUR DISCUSSANT; SCT EJEMETE SUNDAY CORDINATOR; SCT AKINSOLA PEACE FEBRUARY, 2023. 14-Mar-23
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OUTLINE INTRODUCTION ETIOLOGY PATHOPHYSIOLOGY EPIDEMIOLOGY LABORATORY INVESTIGATIONS CONCLUSSION RECOMMENDATION REFERENCES 2 14-Mar-23
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3 INTRODUCTION The imbalance between the production of reactive oxygen species(ROS) and a biological systems ability to readily detoxify the reactive intermediates or inability to easily repair the resulting damage is know as Oxidative stress.(Agarwal et al., 2023) The production of ROS is a normal physiological process, but an imbalance creates an enhanced levels of ROS (Reactive Oxygen Species such as hydrogen peroxide, superoxide anion, hydroxyl radical, nitrogen radicals from reactive nitrogen species) in extracellular fluid of which is detrimental to the same body producing it. www.wjmh.org The international Committee for Monitoring Assisted Reproductive Technologies(ICMART), defines infertility as the inability to conceive after 1year of regular, unprotected intercourse. (World J men’s Health, 2023) 14-Mar-23
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4 What are even this ROS and how do they come about ? 14-Mar-23
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14-Mar-23 5 ETIOLOGY Sharma and Agarwal,,2020.
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6 WHAT HAPPENS NEXT WITH THIS ROS PRODUCED IN OUR BODY 14-Mar-23
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14-Mar-23 7 Sharma and Agarwal,,2020.
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14-Mar-23 8 PATHOPHYSIOLOGY Sharma and Agarwal,,2020.
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14-Mar-23 9 PATHOPHYSIOLOGY (Sharma and Agarwal, 2020
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EPIDEMIOLOGY WHO estimates that nearly 190 million people struggle with infertility worldwide with at least 30 million infertile men in the prevalence of2.5%-15% (Rowe et al., 2015). Among couples unable to conceive, infertility is partially a wholly attributable to a male factor in approximately 50% of cases. Infertility remains undefined in 30% - 50% of idiopathic male factor. A similar high incidence of OS was reported in a recent clinical trial, with 83.8%(124 of 148 cases) of idiopathic infertile men, having positive seminal oxidation reduction potential (ORP). One of the mechanisms proposed for idiopathic male infertility is oxidative stress(OS). So many genetic factors, hypogonadism, cryptorchidism also varicocele, can cause infertility. However, no underlying cause can be identified for primary or secondary infertility in approximately 25% of idiopathic infertility 10 14-Mar-23 Rowe et al., 2015.
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11 General statistics of infertility in Nigeria National Institute for Health and care, 2023. 14-Mar-23
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12 LABORATORY INVESTIGATION. Assessment of sperm ROS levels among infertile men can aid in determining which individuals who may benefit for anti oxidant therapy. Currently, there are no infertility guidelines that recommend routine ROS measurement and there is still an ongoing debate on which type of patients have to be tested for oxidative burden. Asthenozoospermia in a semen sample is probably a marker of ROS. Hyperviscosity has also been suggestive of increased OS because it is attributed to increased malondialdehyde levels. Increase leukocytes or round cells which is one of the principal sources of ROS may suggest further testing for OS. Hyper-osmotic swelling test suggests membrane damage in the sperm due to lipid peroxidation and this might imply higher levels of ROS in semen. 1 2 3 4 Panner et al., 2021 14-Mar-23
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14-Mar-23 13 LABORATORY DIAGNOSIS Various tests have been developed to detect seminal ROS levels which can be classified into direct and indirect assays. Direct assays measure cellular levels of ROS. While, Indirect assays measure the oxidative damage caused by these ROS.
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14-Mar-23 14 Direct assays Chemiluminiscence Nitro blue tetrazolium(NBT) Fluorescein probe Oxidation Reduction Potential(ORP) Indirect assays Lipid Peroxidation(LPO) Antioxidant Total antioxidant capacity(TAC) DNA damage Advantages and diadvantages of these assays. Follow me on https://www.ncbi.nIm.nih.gov/pmc/articles/PMC5922001/#!po=48.9583 g2chibexy@gmail.com, Chibueze.Favourji@facebook.com, whatsapp @09025044187
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14-Mar-23 15 Chemiluminiscence Extremely sensitive and react with a variety of intracellular and extracellular ROS at neutral pH in the presence of a suitable catalyst. Probe such as luminol or lucigenin Blank PBS only Negative PBS + luminol Positive H2O2+ luminol Test Liquefied semen sample ROS measure for 15min and results expressed as relative light units/s/10^6 sperms/mL. Reference value for normal ROS obtained by this method is <102 relative light units/s/10^6 sperm/mL Limitations of luminometer Cannot be performed in patients samples with low volume 800ul sample is required to run in duplicate. Cannot measurer in frozen samples. Whilst being sensitive, confounding variables such as presence of leukocytes could interfere with laboratory results- In such case, use of magnetic beads coated with a monoclonal antibody or use of fluorescent probes are used. Agarwal et al., 2023
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14-Mar-23 16 Agarwal et al., 2023
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14-Mar-23 17 Measurement of Total Antioxidants in Seminal Fluid TAC measures total antioxidant available in a sample Both enzymatic and non-enzymatic and presence of macromolecules The TAC is measured in a clear seminal fluid after removing al cellular components from the seminal ejaculate. By comparing to standard Trolox, a water soluble tocopherol analogue, the amount of antioxidant is measured in the sample by a colorimeter TAC assay kit is used as follows H2O2 Initiates the reaction TAC inhibits ABTS(2,2’azino-di-3-ethylbenzthiazolinesulfonate ABTS.+ metmyoglobin Under this induced reaction condition The antioxidant in the seminal plasma suppress the absorbance at 750nm to a degree that is proportional to the conc. of antioxidant Agarwal et al., 2023
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14-Mar-23 18 The unit of measurement of TAC is micromoles Trolox equivalent. Reference for normal antioxidant value in a sample is >1950 micromoles Trolox equivalent. values of TAC indicates OS or reduced ability of antioxidant to scavenge the formation of ROS in semen samples of infertile men. Agarwal et al., 2023
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14-Mar-23 19 Measurement of OS by ORP ORP is a novel direct measurement of OS or redox imbalance in biological samples. It is correlated with illness, injury and severity in trauma patients. Concentration of both oxidants and antioxidants Provides a global overview of the redox status of semen sample. Is this possible ❓ It involves the transfer of electron from a reductant(or an oxidant) to an oxidant. Measuring redox potential in a biological system. It’s a galvanostat-based tech. using a Male Infertility Oxidative System(MiOXSYS). Agarwal et al., 2023
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14-Mar-23 20 It consist of a MiOXSYS analyser and the sensor strip 30uL of completely liquedified semen sample is loaded on the sample port and measured for 4min. It is measured in millivolts(mv) The ORP values are normalized by the sperm concentration and expressed as mV/10^6 sperm/mL. ORP values >1.37mV/10^6sperm/Ml are indicative of OS. Unlike assessment of single marker, ORP can function as an independent test for semen quality in male infertility. Current evidence suggest that measurement of ORP can serve as a standalone test or a combination of laboratory measures of semen parameters such as conc. Motility, total sperm con. Can further improve specificity and positive predictive value of this test Measurement of OS by ORP Agarwal et al., 2023
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14-Mar-23 21 ncbi, 2023, Agarwal et al., 2023
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14-Mar-23 22 Advantage of ORP Being a promising new andrology laboratory test, it is able to distinguish not only abnormal and normal semen quality but also descriminate between semen from fertile and infertile patients with specific thresholds. Less time consuming Requires little or no expertise. Measure both fresh and frozen samples. ncbi, 2023, Agarwal et al., 2023
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CONCLUSION Despite the vital function of ROS during fertilization, an increase in those free radicals causes oxidative stress and detrimentally affects sperm function. The origin of this increase arises from different endogenous and exogenous sources, such as sperm metabolism or infections, respectively. It is well known that ROS cause a reduction in sperm count and motility, protein alterations, lipid peroxidation, and DNA fragmentation, amongst others. This problem of infertility due to oxidative stress or other reasons, can be solved by Antioxidant supplementation such as glutathione and/ or Assisted Reproductive Techniques, ART (Agarwal et al., 2021). 23 14-Mar-23
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RECOMMENDATION Infertility testing should also be considered significant as related to oxidative stress monitoring in semen analysis. Chemical pathology unit in FMC Jabi should consider diagnostic methods for general oxidative stress particularly ORP considering its advantage. Minimize ‘lifestyle’ that triggers oxidative stress. Such as avoid smoking, excessive alcohol intake and improved diet, Minimize environmental exposure to heat, pollution and toxins. Vitamin and antioxidant supplements, to decrease ROS production. Supplementation of antioxidant such as glutathione and/ Assisted Techniques ART to reduce oxidative stress and improve sperm motility could be useful in management of male infertility. General populace awareness in educating the risk factors associated with oxidative stress should be practice in conjunction to the adverse effect in humans. 24 Considering the following studies, I would recommend that; 14-Mar-23
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14-Mar-23 25 THANKS FOR LISTENING
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REFERENCE Banerjee P, Bhattacharya J. Impact of Oxidative stress on Infertility, with emphasis on infertility management strategies. Global Journal of Fertility and Research. 2019 Aug 2;4(1):010-8. Bisht S, Faiq M, Tolahunase M, Dada R (2017) Various factors contributing to oxidative stress and bringing about male infertility, digital photograph. Nature Reviews, Urology 14. 472-485 Louis J.F., Thoma M.E., Sørensen D.N., McLain A.C., King R.B., Sundaram R., Keiding N., Buck Louis G.M. The prevalence of couple infertility in the United States from a male perspective: Evidence from a nationally representative sample. Andrology. 2013;1:741–748. Pereira R, Sá R, Barros A and Sousa M (2017) Causes that lead to oxidative stress condition, digital photograph. Asian journal of andrology. Link: http://bit.ly/332yEPr 26 14-Mar-23
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REFERENCE cont’d Sharma, R. K., and Agarwal, A. (1996). Role of reactive oxygen species in male infertility,” Urology, 48, 6, 835-850. Slade P, O'Neill C, Simpson AJ, Lashen H. The relationship between perceived stigma, disclosure patterns, support and distress in new attendees at an infertility clinic. Hum Reprod. 2007;22:2309–17. Tremellen K. Oxidative stress and male infertility—a clinical perspective. Human reproduction update. 2008 May 1;14(3):243-58 Uadia PO, Emokpae AM. Male infertility in Nigeria: A neglected reproductive health issue requiring attention. Journal of Basic and Clinical Reproductive Sciences. 2015 Jul 21;4(2):45-53. Valko, M., Morris, H., and Cronin, M. T. D. (2015). Metals, toxicity and oxidative stress, Current Medicinal Chemistry, 12, 10, 1161-1208. 27 14-Mar-23