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Title: Metformin, Oxidative Stress and Male Infertility: Way Forward
Authors: Faiza Alam , Nida Farooqui , Rehana Rehman
Journal: Journal of Pakistan Medical Association
Publisher: Pakistan Medical Association.
Country: Pakistan
Year: 2021
Volume: 71
Issue: 2
Language: en
Madam,
There is an increased prevalence of infertility in male population. With reference to a variety of mechanisms, oxidative stress (OS) is responsible for alteration in  structural and functional integrity of sperm leading to altered sperm parameters, hence leading to infertility (1).
Metformin though proved to be a first-line hypoglycemic agent has demonstrated antioxidant properties in numerous tissues. It inhibits the mitochondrial respiratory chain in the liver, which leads to stimulation of AMP-activated protein kinase (AMPK)-dependent as well as AMPK-independent mechanisms (2). Metformin triggers alanine production within the Sertoli cells (SCs,) balances  the NADH/NAD+ equilibrium and provides antioxidant environment. This drug is a treatment of choice in treating females with Polycystic Ovaries (PCOS) on the basis of its capability to reduce insulin sensitivity as well as angiogenesis through the nuclear factor ?B (NF-?B) pathway which renders it to reduce oxidant species, thus improving the reproductive environment (3). Continuous....
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