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The apoptotic process involves distinct pathways with different protein, and can be triggered either by intrinsic factors, such as extensive DNA damage, ischemia, oxidative stress, or infections, or by extrinsic factors, which involve the interaction of specific membrane receptors with pro-apoptotic molecules produced elsewhere

Furthermore, inactivation of key androgenic enzymes, such as 3-hydroxysteroid dehydrogenase and 17-hydroxysteroid dehydrogenase, together with decreased testosterone synthesis suggest a potential impairment of male gonadal function