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Finally, because our subjects were all Americans, the external applicability of this study needs to be verified by future multicenter prospective research, and the limitations of previous studies need to be addressed

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however, in cases of azoospermia, severe oligozoospermia, or severely abnormal sperm parameters, sperm may be obtained via aspiration of the epididymis, vas deferens, or testes, or through microsurgical dissection of the testes

In addition, vitamin E deficiency also leads to the aggravation of renal IRI [184]

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These data along with our findings using autoantibodies (Fig