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Dietary DHA intake data were obtained by food frequency questionnaire and tobacco smoke exposure levels were evaluated by serum cotinine levels

4.1 Cardiac surgery (heart and systemic organ protection) Cardiac surgeries like coronary artery bypass grafting (CABG) or valve replacement commonly utilize cardiopulmonary bypass (CPB), which triggers a significant systemic inflammatory response due to blood contact with artificial surfaces, ischemia-reperfusion of the heart, and global hypothermia/rewarming (166, 167)

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These molecules enhance blood flow to testicular tissue, reduce inflammatory markers that impair sperm production, and support the hormonal environment necessary for optimal fertility