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Substance-use screening is handled directly: an opt-out exclusionary block flags current alcohol, opioid, or substance-use disorder, and a separate three-month opiate-history field requires free-text date range, name, dose, and frequency before the patient can advance

Lifestyle Factors That Enhance Antioxidant Effectiveness Antioxidants work best when combined with: Healthy Diet: Mediterranean-style eating pattern with 5-7 servings of fruits and vegetables daily Reduce Oxidative Stress: Stop smoking, limit alcohol, minimise processed foods Regular Exercise: Moderate activity 30-45 minutes, 5 days per week Stress Management: 7-9 hours quality sleep, mindfulness practices Avoid Heat: No hot baths/saunas, wear loose-fitting underwear Maintain Healthy Weight: BMI between 20-25 Beyond Antioxidants: A Complete Approach to Male Fertility While antioxidants are powerful tools for improving sperm health, they work best as part of a comprehensive fertility strategy

Ensure adequate daily intake of: Calcium : Adults typically require 700mg daily (NHS recommendation), obtainable through dairy products, fortified plant-based alternatives, leafy green vegetables, and tinned fish with bones

We conclude by discussing existing gaps in the literature and proposing directions for future research

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