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Across all six studies, the safety findings were consistent: no serious adverse events, no immunogenic responses, no changes in IGF-1, no glucose or insulin disruption

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MDA, a byproduct of lipid peroxidation, serves as a key biomarker of OS and exhibits cytotoxic effects on spermatozoa

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Ex-4 also modulates the influx of calcium through L-type voltage-dependent calcium channels (L-VDCCs) and N -methyl-d-aspartate receptors, and it maintains the expression of phosphorylated calcium/calmodulin-dependent protein kinase type II [73]