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The excessive generation of reactive oxygen species (ROS) by abnormal spermatozoa and by contaminating leukocytes has been identified as one of the few defined aetiologies for male infertility. As a consequence, work has begun on evaluating the role of antioxidants in the management of these patients. Glutathione plays a significant role in the antioxidant defences of the spermatogenic epithelium, the epididymis, and perhaps in ejaculated spermatozoa. The use of antioxidants in vitro appears to be of value in preserving fertilizing capacity, although no clinical data are available. Glutathione administered in vivo to patients who may have infertility secondary to excessive oxidative stress appears to act at the epididymis and during spermatogenesis, to improve the function of ejaculated spermatozoa. However, fertility studies have not yet been conducted. Controlled studies of glutathione and other antioxidants in patients with defined ROS pathology are urgently required.
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