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These changes can cause a cascade of oxidative damage that can systemically make its way to the male reproductive system, thereby affecting fertility

doi: 10.1128/mBio.01691-19 138 ZhuZ.ZhouY

J Biol Chem 289:16621674

In peripheral tissues, BHB is oxidized into AcAc in the reverse reaction catalyzed by BDH1 (Newman and Verdin, 2017

Hashimoto A, Nishikawa T, Oka T, Takahashi K

Conclusion Over the years, melatonins properties unfolded as a circadian regulator, anti-inflammatory, anti-oxidant, immune modulator, iron chelator, and, lately, an anti-ferroptosis