Male infertility can be caused by structural or functional abnormalities in sperm, including low sperm count, low motility, and abnormal forms. Oxidative stress from reactive oxygen species is another leading cause, as it can damage sperm DNA and membranes. The body normally defends against oxidative stress through antioxidant enzymes and compounds in seminal plasma. However, oxidative stress overwhelms these defenses in around 25-40% of infertile men. Various antioxidants taken as supplements, either alone or in combination, have been shown to reduce oxidative stress levels, boost sperm parameters, and improve fertility rates. These include CoQ10, lycopene, mixed carotenoids, omega-3 fatty acids, vitamin C, vitamin E, selenium, zinc
Ovulation Induction - Simplified - Dr Dhorepatil BharatiBharati Dhorepatil
What are factors to be considered
Ovarian reserve
Previous ovarian response
Basic hormone profile
Role of FSH & LH
Trigger
Luteal phase support
Pregnancy rate/cycle
Invited Lecture delivered by Dr Sujoy Dasgupta in a CME, sponsored by Serum Institute of India Pvt Ltd in the Convocation Ceremony of Interns at Sagor Dutta Medical College
Ovulation Induction - Simplified - Dr Dhorepatil BharatiBharati Dhorepatil
What are factors to be considered
Ovarian reserve
Previous ovarian response
Basic hormone profile
Role of FSH & LH
Trigger
Luteal phase support
Pregnancy rate/cycle
Invited Lecture delivered by Dr Sujoy Dasgupta in a CME, sponsored by Serum Institute of India Pvt Ltd in the Convocation Ceremony of Interns at Sagor Dutta Medical College
This ppt gives you an expert's overview of semen analysis, its pitfalls and important clinical information that could be used in assessing an infertile male when he presents to a fertility clinic
Novel concepts in male factor infertility: clinical and laboratory perspectivesSandro Esteves
Presentation Objectives:
1. Update on the WHO reference values for semen parameters, and understand the role of sperm DNA fragmentation testing to decision-making strategies;
2. Learn how to counsel azoospermic men seeking fertility, and the role of gonadotropin therapy in this infertility condition;
3. Understand the benefits of microsurgery to both sperm retrieval and varicocele treatment;
4. Appraise the role of medical and surgical interventions to infertile men undergoing ART.
Role of Antioxidants in the Treatment of Male Infertility-Crimson PublishersCrimsonpublisherssmoaj
Stress is defined as a general body response to initially threatening external or internal demands, involving the mobilization of physiological and psychological resources to deal with them. Recently, oxidative stress has become the focus of interest as a potential cause of male infertility. Normally, equilibrium exists between reactive oxygen species (ROS) production and antioxidant scavenging activities in the male reproductive organs. Non-hormonal medical treatment has been proposed for patients with idiopathic or non-curable oligo-astheno-terato-zoospermia and for normo-zoospermic infertile patients. Anti-inflammatory, fibrinolytic & antioxidant compounds, oligo elements and vitamin supplementation may be prescribed. Infection, inflammation and/or increased oxidative stress often require a specific treatment with antibiotics, anti-inflammatory drugs and/or antioxidants. The ascorbic acid is a known antioxidant present in the testis with the precise role of protecting the male reproductive organs from the oxidative damage. It also contributes to the support of spermatogenesis at least in part through its capacity to maintain antioxidant in an active state. Combined therapies can contribute to improve sperm quality.
Nutrients present in Nutrease powder play an important role in maintaining the normal functions of the human body. The major nutrients present in Nutrease powder include Natural carbohydrates, proteins, lipids, vitamins, and minerals. Besides these, there are some bioactive food components known as “phytonutrients” that play an important role in human health. They have tremendous impact on the health care system and may provide medical health benefits including the prevention and/or treatment of disease and various physiological disorders such as Andropause or Male menopause. Phytonutrients play a positive role by maintaining and modulating immune function to prevent specific diseases. Being natural products, they hold a great promise in clinical therapy. Phytonutrients in Nutrease powder are the plant nutrients with specific biological activities that support human health. Some of the important bioactive phytonutrients in Nutrease powder include polyphenols, terpenoids, resveratrol, flavonoids, isoflavonoids, carotenoids, limonoids, glucosinolates, phytoestrogens, phytosterols, anthocyanins, and probiotics. They play specific pharmacological effects in human health such as anti-microbial, anti-oxidants, anti-inflammatory, anti-allergic, anti-spasmodic, anti-cancer, anti-aging, hepatoprotective, hypolipidemic, neuroprotective, hypotensive, diabetes, osteoporosis, CNS stimulant, analgesic, protection from UVB-induced carcinogenesis, immuno-modulator, and carminative. This article reviews the current available scientific literature regarding the effect of Nutrease powder as an effective supplementation in Male & Female Fertility.
Role of antioxidants in female infertility Dr. Jyoti AgarwalLifecare Centre
Role of antioxidants in female infertility Dr. Jyoti Agarwal
3 Concepts
Oxygen toxicity is an inherent challenge to aerobic life
Oxygen is essential for life.
Excess oxygen can have harmful effects.
When oxygen is metabolised in the body , it produces substances called FREE RADICALS which damage our cells.
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By Prof. ATEF DONIA Professor of Pediatrics Al Azhar University
The role of reactive oxygen species (ROS) in pathogenesis of common disorders of the preterm infant.
The unique susceptibility of premature infants to oxidative stress. Potential for therapeutic interventions using enzymatic and/or non-enzymatic antioxidants
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Role of Oxidative Stress on male infertilityFavourji
Oxidative stress is associated with several body cell damage which can result into cell death and eventually mortality. Its a key factor in several infertility cases and with the knowledge of its impact a lot can be known to avert its further implications.
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
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- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
4. Male infertility
• Male infertility of unknown origin is a
condition in which fertility impairment occurs
spontaneously or due to an obscure or
unknown cause
• It includes 2 categories,
1. Unexplained male infertility, &
2. Idiopathic male infertility.
• The dividing line between them is semen
analysis, which is normal in the unexplained
category and abnormal in idiopathic infertility.
6. Causes - male infertility
When there is structural abnormality in the sperms
When there is structural abnormality in the sperms
When there is functional abnormality in the sperms
When there is functional abnormality in the sperms
7. Causes - male infertility
When Number is < 1m/ejaculate
When Number is < 1m/ejaculate
When Motility is < 20%
When Motility is < 20%
When Progression is < 2/4
When Progression is < 2/4
When Abnormal forms are > 85%
When Abnormal forms are > 85%
8. Causes - oxidative stress
• Oxidative stress (OS) is the imbalance
between the production of reactive oxygen
species (ROS) by the spermatozoa and
leukocytes & the antioxidant capacity of the
seminal plasma.
1. The primary source of ROS production in
infertile patients is the immature spermatozoa.
2. Oxidative stress can damage the DNA of the
spermatozoa & prevent them fertilizing an egg.
3. Reactive oxygen species (ROS) includes
oxygen ions, free radicals and peroxides.
10. Causes - inadequate sperm motility
• Semen parameters, reactive oxygen species
(ROS) levels & DNA fragmentation index
(DFI) in normozoospermic infertile men and
controls
– Indian J Med Res. 2011 September; 134(3):
396–398.
11. Causes-inadequate progression
Grade 0 is no movement
Grade 0 is no movement
Grade 1 is sluggish movement
Grade 1 is sluggish movement
Grade 2 is slow movement but not straight
Grade 2 is slow movement but not straight
Grade 3 is movement in a straight line
Grade 3 is movement in a straight line
Grade 4 is terrific speed.
Grade 4 is terrific speed.
16. ROS - role in male infertility
Idiopathic oxidative stress has been linked with male factor
Idiopathic oxidative stress has been linked with male factor
infertility as it is known to contribute to defective
infertility as it is known to contribute to defective
spermatogenesis leading to male factor infertility
spermatogenesis leading to male factor infertility
Uncontrolled & excessive production of ROS overwhelms the
Uncontrolled & excessive production of ROS overwhelms the
limited antioxidant defenses in semen resulting in seminal
limited antioxidant defenses in semen resulting in seminal
oxidative stress
oxidative stress
Seminal oxidative stress correlates negatively with sperm
Seminal oxidative stress correlates negatively with sperm
concentration, motility and function -- adversely affecting fusion
concentration, motility and function adversely affecting fusion
events required for fertilization.
events required for fertilization.
Superoxide anion, hydroxyl radical and hydrogen peroxide
Superoxide anion, hydroxyl radical and hydrogen peroxide
are major reactive oxygen species (ROS) present in seminal
are major reactive oxygen species (ROS) present in seminal
plasma.
plasma.
17. ROS - role in male infertility
ROS are produced by the spermatozoa (especially damaged
ROS are produced by the spermatozoa (especially damaged
spermatozoa) & seminal leucocytes --most notably granulocytes.
spermatozoa) & seminal leucocytes most notably granulocytes.
Reports have indicated that high levels of ROS are detected
Reports have indicated that high levels of ROS are detected
in semen samples of 25-40% of infertile men & seems to be
in semen samples of 25-40% of infertile men & seems to be
the leading cause infertility by 2 principal mechanisms:
the leading cause infertility by 2 principal mechanisms:
ROS damage the sperm
ROS damage the sperm ROS directly damage sperm
ROS directly damage sperm
membrane by causing lipid
membrane by causing lipid DNA, compromising the
DNA, compromising the
peroxidation of sperm
peroxidation of sperm paternal genomic
paternal genomic
membrane
membrane contribution to the embryo
contribution to the embryo
This, in turn, reduces the sperm’s motility and ability to fuse with
This, in turn, reduces the sperm’s motility and ability to fuse with
the oocyte.
the oocyte.
18. Body's defence against ROS
To maintain normal
To maintain normal Excess ROS is continuously inactivated
Excess ROS is continuously inactivated
cell function
cell function by seminal plasma antioxidants
by seminal plasma antioxidants
The seminal plasma antioxidants block the formation of new ROS or act
The seminal plasma antioxidants block the formation of new ROS or act
as scavengers and remove ROS already generated
as scavengers and remove ROS already generated
Natural antioxidant enzyme systems include
Natural antioxidant enzyme systems include
Glutathione
Glutathione Superoxide
Superoxide
Catalase
Catalase
peroxidase
peroxidase dismutase
dismutase
19. Body's defence against ROS
In healthy men, a delicate balance exists
between physiological ROS and
antioxidants in the male reproductive
tract
20. Underlying facts on anti-oxidants
Antioxidants are the most important defence against free radical induced
Antioxidants are the most important defence against free radical induced
infertility
infertility
The several antioxidant strategies produced by the human body protect
The several antioxidant strategies produced by the human body protect
itself from ROS damage
itself from ROS damage
This permits normal oxidative metabolism to occur without damaging the
This permits normal oxidative metabolism to occur without damaging the
cells, while still allowing for normal ROS-mediated cellular responses
cells, while still allowing for normal ROS-mediated cellular responses
such as destruction of infectious pathogens and intracellular signalling
such as destruction of infectious pathogens and intracellular signalling
However in conditions of oxidative stress, production of ROS
However in conditions of oxidative stress, production of ROS
overwhelms antioxidant defence.
overwhelms antioxidant defence.
Hence, there is a pressing need for external
Hence, there is a pressing need for external
antioxidant support!
antioxidant support!
21. The need of the day
• Levels of ROS within semen can be ↓ by
augmenting the scavenging capacity of
seminal plasma, by antioxidant supplement.
But, what can antioxidant do to the
But, what can antioxidant do to the
problem of male infertility?
problem of male infertility?
Antioxidant supplements boost sperm count, morphology and sperm
Antioxidant supplements boost sperm count, morphology and sperm
motility and prevent DNA damage to sperm
motility and prevent DNA damage to sperm
22. What we need to know
The therapeutic supplementation
in male infertility
23. Clomiphene – Role in male fertility
• Clomiphene citrate influences spermatogenesis
and also improves semen quality
25. Antioxidants in the therapy of
male infertility
Because ROS have been associated with
sperm DNA damage, investigators have
studied possible protective roles of
antioxidants in preventing or treating sperm
DNA damage.
Sperm DNA damage in male infertility: etiologies, assays,
and outcomes by Ryan Tet al, J Assist Reprod Genet. 2010
January; 27(1): 3–12.
26. Antioxidants in the therapy of
male infertility
82% trials showed an improvement in either
sperm quality or pregnancy rate after
antioxidant therapy.
10 trials examined pregnancy rate and 6 showed
a significant improvement after antioxidant
therapy.
The use of oral antioxidants in infertile men could
improve sperm quality and pregnancy rates.
A systematic review of the effect of oral antioxidants on male
infertility by C. Ross et al, Reproductive BioMedicine Online,
Volume 20, Issue 6, Pages 711-723, June 2010
27. Antioxidants in the therapy of
male infertility
Ubidecarenone
Carotenoids
(Lycopene)
Omega 3 fatty acids
Carnitine
Vitamin E & Vitamin C
Selenium
Glutathione
N-acetyl cysteine
Pentoxifylline
Trace Metals like Zinc
Vitamin B12
28. Ubidecarenone
• Also known as Coenzyme Q10,
ubiquinone, coenzyme Q, and abbreviated
at times to CoQ10 , CoQ, Q10, or Q
• Component of the electron transport chain
and participates in aerobic cellular
respiration, generating energy as ATP.
• Unique capacity of this molecule:
To exist in a completely Enables it to function in the electron
oxidized form transport chain
To exist in a reduced Enables it to function as an antioxidant
form
29. Ubidecarenone - Role in male fertility
• In sperm cells, Co Q10 is concentrated in the
mitochondrial mid-piece, where it is involved
in energy production.
• It also functions as an antioxidant, preventing
lipid peroxidation of sperm membranes.
• According to studies, Ubidecarenone shows
significant increase in:
sperm motility
sperm density
improvement in fertilization rate
30. Lycopene - Role in male fertility
• Bright red carotenoid pigment,
phytochemical and powerful antioxidant with
a major role in the management of idiopathic
male infertility.
– Most efficient oxygen & free radical quencher
and prime carotenoid in plasma / other tissues
– It is a component of human redox defence
mechanism against free radicals
• Found in high concentrations in the testes
and seminal plasma
– Decreased levels have been demonstrated in
31. Lycopene - Role in male fertility
• Studies suggest efficacy of lycopene in male
infertility as it improves.
– Sperm Concentration
– Sperm Motility
– Sperm Morphology
32. Mixed caretenoids - Role in male
fertility
• Carotenoids work synergistically with Se and
vitaminE
• Mixed carotenoids, taken with vitamins C
and E, may help protect sperm from damage
by free radicals as it improves -
– Sperm Motility
– Sperm Morphology
– Sperm Concentration and
– Improved Fertility rates
33. Omega-3 fatty acids - Role in male
fertility
• Omega−3 fatty acids includes
eicosapentaenoic acid (EPA) and
docosahexaenoic acid (DHA).
• DHA (Docosahexaenoic acid) is essential for
male fertility.
– Omega-3 fatty acids are abundant in the sperm
with DHA being abundant in the sperm tail to
have significant effect in sperm motility.
• Its deficiency is linked to low sperm count
and infertility.
34. Omega-3 fatty acids - Role in male
fertility
• Normal sperm cells contain an arc-like
structure called the acrosome. Acrosome is
critical in fertilization because it houses,
organizes, and concentrates a variety of
enzymes that sperms use to penetrate egg.
– DHA is essential in fusing the building blocks of
the acrosome together.
– Without DHA, this vital structure does not form
and sperm cells don't work
– DHA plays a major role in regulating membrane
fluidity in sperm + regulation of spermatogenesis
36. Wheat germ oil - Role in male fertility
• Source of Vitamin E and primary function is
as an Antioxidant
• It is a major chain-breaking antioxidant in
the sperm membranes
– Protects the sperm membrane from oxidative
damage and increased levels are associated
with low levels of reactive oxygen species.
• It scavenges all 3 types of free radicals, viz.
– Superoxide,
– Hydrogen peroxide and
– hydroxyl radicals.
37. Wheat germ oil - Role in male fertility
• Vitamin E enhances sperm performance
• Vitamin E protects spermatozoa from:
1. Oxidative damage
2. Loss of motility
• Male factor infertility: Effects of ROS and
vitamin E on sperm by Melanie Clyne,
Nature Reviews Urology 9, 62 (February
2012)
38. Calcium ascorbate – Role in male
fertility
• Natural form of Vitamin C that is a water-
soluble ROS scavenger with high potency.
• Readily absorbed in the blood stream than
the other forms of calcium.
• It is a strong antioxidant destroying free
radicals in the body and protects human
spermatozoa against endogenous oxidative
damage by neutralising :
1. Hydroxyl
2. Superoxide, &
3. Hydrogen peroxide radicals
39. Calcium ascorbate – Role in male
fertility
• Vitamin C Prevents sperm agglutination.
• Vitamins C and E act synergistically to
protect against peroxidative attack on
spermatozoa.
40. Vitamin B 12 - Role in Male Fertility
• Vitamin B12 is important in cellular
replication, especially for the synthesis of
RNA and DNA
• Deficiency states have been associated with
decreased sperm count and motility
• B12 supplementation improves sperm
parameters such as:
1. Sperm concentration,
2. Sperm count and
3. Sperm motility.
41. Selenium - Role in Male Fertility
• Selenium is a nonmetal & a trace mineral
that is essential to good health but required
only in small amounts.
• Its antioxidant properties helps prevent
cellular damage from free radicals
• Protects against oxidative sperm DNA
damage and is required for:
1. Normal testicular development
2. Spermatogenesis
3. Motility and function
42. Selenium - Role in Male Fertility
• Essential for formation of phospholipid
hydroperoxide glutathione peroxidase - an
enzyme present in spermatids which
becomes a structural protein comprising over
50 % of the mitochondrial capsule in the mid-
piece of mature spermatozoa.
– Deficiency leads to instability of the mid-piece,
resulting in
• Defective motility
• Breakage of the spermatozoal mid-piece and
• Increased morphological abnormalities, mostly
affecting the sperm head
43. Zinc - Role in male fertility
• Zinc is a trace mineral essential for normal
functioning of the male reproductive
system.
• Zinc levels are generally lower in infertile
men with diminished sperm count
– Zinc supplementation shows improvement in
sperm quality, sperm motility, fertilisation
capacity and a reduction in the incidence of
anti-sperm antibodies.
44. Zinc - Role in male fertility
• Zinc is found in high concentration in sperm,
and is vital in making the outer layer of the
sperm, as well as the tail.
– Zinc deficiency is associated with decreased
testosterone levels and sperm count
• Administration of exogenous systemic zinc to
males with zinc deficiency can improve
sperm production and sperm motility.
– Supplementing zinc in the diet can re-establish
testosterone and sperm count levels to
acceptable levels
45. Zinc - Role in male fertility
• Omu et al. have demonstrated that zinc
therapy results in significant improvement in
sperm quality with increase in sperm density,
progressive motility and improve conception
and pregnancy outcome
– Oxidative stress adversely affects spermatogenesis in
male infertility by Z.G. Badade et al, Biomedical
Research 2011, 22 (3): 323-328
46. Piperine
• Piperine is an alkaloid - a standardized
extract from the fruits of Piper nigrum L.
(black pepper) or Piper longum L. (long
pepper)
• Piperine may be co-administered with
various nutrients for human health.
– It has antioxidant activity
– It lowers lipid peroxidation
– It increases the plasma levels of Coenzyme Q10
following oral supplementation.