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Signs of complications that necessitate urgent medical attention include severe bleeding leading to anaemia (symptoms: fatigue, pallor, breathlessness), fever or signs of infection, or inability to control bowel movements

This leads to the production of malondialdehyde (MDA) and 4-hydroxynonenal (4HNE), which oxidises the lipid membrane and causes fragmentation of both nuclear and mitochondrial DNA in sperm (de Lamirande & Gagnon 1992, Kodama et al

[DOI] [PMC free article] [PubMed] [Google Scholar] 17.Bartelt A., Heeren J

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