Is male infertility associated with increased oxidative stress in seminal plasma? A-meta analysis

// Chao Huang 1, 2, * , Xiyue Cao 1, 2, * , Dejiang Pang 3, * , Chao Li 1, 2 , Qihui Luo 1, 2 , Yuanfeng Zou 2 , Bin Feng 4 , Lixia Li 2 , Anchun Cheng 1, 2 and Zhengli Chen 1, 2 1 Laboratory of Experimental Animal Disease Model, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu 611130, China 2 Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu 611130, China 3 Department of Biochemistry and Molecular Biology, West China School of Preclinical and Forensic Medicine, West China Hospital, Sichuan University, Chengdu 610041, China 4 Animal Nutrition Institute, Sichuan Agricultural University, Chengdu 611130, China * These authors contributed to the work equally Correspondence to: Zhengli Chen, email: chzhli75@163.com Keywords: oxidative stress; antioxidants; male infertility; meta-analysis; markers Received: June 22, 2017 Accepted: March 22, 2018 Published: May 11, 2018 ABSTRACT Objectives: We conducted a systematic review and meta-analysis of observational case-control studies to evaluate markers of oxidative stress in seminal plasma of patients with male infertility. Background: Current evidence links oxidative stress to male infertility, in which multiple markers of oxidative stress have been widely detected, publishing inconsistent results with regard to the role of oxidative stress markers in the evaluation of male infertility. Therefore, a systematic review and meta-analysis on this issue is necessary. Results: From the 1024 articles initially retrieved, 65 studies were included in our meta-analysis with 11 oxidative stress markers, containing 3819 male infertility patients and 2012 controls. The concentrations of malondialdehyde (SMD = 1.86, p < 0.00001), NO (SMD = 0.89, p = 0.001), carbonyl protein (SMD = 2.09, p < 0.00001) in seminal plasma were significantly higher in infertility patients. The concentrations of GSH (SMD = –1.68, p < 0.00001), vitamin C (SMD = –1.12, p < 0.00001), and vitamin E (SMD = –1.48, p = 0.003), as well as the activities of catalase (SMD = –1.91, p < 0.0001), glutathione peroxidase (SMD = –1.96, p = 0.0002) and glutathione-S-transferase (SMD = –1.62, p = 0.009) declined remarkably, resulting in decreased total antioxidant capacity (SMD = –1.77, p < 0.00001). Besides, the activity of superoxide dismutase showed no statistical difference between infertility patients and controls (SMD = –0.51, p = 0.07). Conclusions: Our meta-analysis suggests that oxidative stress in seminal plasma resulting from decreased antioxidant defense are associated with male infertility. Methods: Using PubMed, EMBASE, CNKI, VIP, and Wanfang database, we searched for literature reporting the detection of oxidative stress markers in the seminal plasma of male infertility published up to June 2017. Standardized mean differences (SMDs) and 95% confidence intervals (95%CI) were calculated for the finally analysis.