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The plethora of physical, chemical, and pathological factors that can apparently contribute to the induction of oxidative stress in the testes is impressive and suggests that the clinical picture will be extremely complex, with each individual being subject to a unique range of causative factors as a result of differences in occupational and environmental exposures, the presence of other pathological factors such as infection or diabetes, and genetic factors that could influence everything from the way in which specific xenobiotics are metabolised to the endocrine environment in which the testes have to function

borderline results may require additional testing of methylmalonic acid (MMA) and/or homocysteine levels for confirmation

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