Table 6. Summary of the Societies’ recommendations on the use of AOX for the treatment of male infertility.

Society	Year	Recommendation
European Academy of Andrology (EAA) [92]	2018	Recommendation 9. According to the current evidence, we cannot recommend either for or against antioxidants, and for antiestrogens (tamoxifen or clomiphene) or aromatase inhibitors (2ØOOO)
American Urological Association (AUA)/American Society for Reproductive Medicine (ASRM) [22]	2021	Recommendation 43. Clinicians should counsel patients that the benefits of supplements (e.g., antioxidants, vitamins) are of questionable clinical utility in treating male infertility. Existing data are inadequate to provide recommendation for specific agents to use for this purpose (Conditional Recommendation; Evidence Level: Grade B) Current data suggest that they are likely not harmful, but it is questionable whether they will provide tangible improvements in fertility outcomes
Italian Society of Andrology and Sexual Medicine (SIAMS) [93]	2021	We recommend against treatment with nutraceuticals/antioxidants in unselected infertile men to increase sperm parameters (Expert Opinion) We suggest considering the use of nutraceuticals/antioxidants in selected patients with idiopathic oligozoospermia and/or asthenozoospermia and/or clear signs of high OS, since in some cases they might improve sperm parameters (2, ØOOO) We cannot recommend either for or against the use of nutraceuticals/antioxidants to increase pregnancy rate (Expert Opinion)
European Association of Urology – Sexual and Reproductive Health Guidelines [94]	2022	No clear recommendation can be made for treatment of patients with idiopathic infertility using antioxidants, although antioxidant use may improve semen parameters (weak)

AOX: antioxidant, OS: oxidative stress.