agxАндрология и генитальная хирургияAndrology and Genital Surgery2070-97812412-890210.17650/2070-9781-2017-18-3-28-36agx-244Research ArticleОБЗОРНАЯ СТАТЬЯREVIEWРОЛЬ МУЖСКОГО ФАКТОРА БЕСПЛОДИЯ В ПРОГРАММЕ ВСПОМОГАТЕЛЬНЫХ РЕПРОДУКТИВНЫХ ТЕХНОЛОГИЙ (ОБЗОР ЛИТЕРАТУРЫ)ROLE OF MALE INFERTILITY IN ASSISTED REPRODUCTIVE TECHNOLOGY PROGRAMS (A LITERATURE REVIEW)ГамидовС. И.GamidovS. I.

отделение андрологии и урологии, 117198 Москва, ул. Академика Опарина, 4;

кафедра акушерства, гинекологии, перинатологии и репродуктологии, 119991 Москва, ул. Трубецкая, 8, стр. 2

Department of Andrology and Urology, 4, Oparina St., Moscow 117198;

Department of Obstetrics, Gynecology, Perinatology, and Reproductology, Build. 2, 8 Trubetskaya St., Моscow 119991

ОвчинниковР. И.OvchinnikovR. I.

отделение андрологии и урологии, 117198 Москва, ул. Академика Опарина, 4;

кафедра акушерства, гинекологии, перинатологии и репродуктологии, 119991 Москва, ул. Трубецкая, 8, стр. 2

Department of Andrology and Urology, 4, Oparina St., Moscow 117198;

Department of Obstetrics, Gynecology, Perinatology, and Reproductology, Build. 2, 8 Trubetskaya St., Моscow 119991

ПоповаА. Ю.PopovaA. Yu.

отделение андрологии и урологии, 117198 Москва, ул. Академика Опарина, 4;

кафедра акушерства, гинекологии, перинатологии и репродуктологии, 119991 Москва, ул. Трубецкая, 8, стр. 2

Department of Andrology and Urology, 4, Oparina St., Moscow 117198;

Department of Obstetrics, Gynecology, Perinatology, and Reproductology, Build. 2, 8 Trubetskaya St., Моscow 119991

НаумовН. П.NaumovN. P.

отделение андрологии и урологии, 117198 Москва, ул. Академика Опарина, 4

Department of Andrology and Urology, 4, Oparina St., Moscow 117198

naumov_niki@mail.ruГасановН. Г.GasanovN. G.

отделение андрологии и урологии, 117198 Москва, ул. Академика Опарина, 4

Department of Andrology and Urology, 4, Oparina St., Moscow 117198

ФГБУ «Национальный медицинский исследовательский акушерства, гинекологии и перинатологии им. В.И. Кулакова» Минздрава России; Института профессионального образования ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава РоссииРоссияV.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of RussiaRussian FederationФГБУ «Национальный медицинский исследовательский акушерства, гинекологии и перинатологии им. В.И. Кулакова» Минздрава РоссииРоссияV.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of RussiaRussian Federation2017101120171832836Copyright © Гамидов С.И., Овчинников Р.И., Попова А.Ю., Наумов Н.П., Гасанов Н.Г., 20172017Гамидов С.И., Овчинников Р.И., Попова А.Ю., Наумов Н.П., Гасанов Н.Г.Gamidov S.I., Ovchinnikov R.I., Popova A.Y., Naumov N.P., Gasanov N.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://agx.elpub.ru/jour/article/view/244

Данный обзор литературы посвящен важнейшей медико-социальной проблеме современной медицины — влиянию роли мужского бесплодия на исходы программ вспомогательных репродуктивных технологий (ВРТ). На сегодняшний день в диагностике и лечении мужского бесплодия можно обозначить целый ряд проблем: отсутствие стандартных тестов для оценки фертильности, неполное знание патофизиологии мужского бесплодия, нехватку специалистов в области андрологии, а также недостаток необходимых технических ресурсов; в этот список можно добавить отсутствие проверенных методов фармакотерапии. По сравнению с успехами в выявлении и лечении женского бесплодия диагностика и терапия мужского, особенно идиопатического, по-прежнему остается малоэффективной и носит в основном эмпирический характер. Достаточно сложно выявить, при каких показателях спермограммы встречаются наиболее часто неудачи программы ВРТ, сопоставить данные неудач ВРТ с показателями патозооспермии и выявить закономерности, а также оценить здоровье детей, зачатых с помощью этой программы. В настоящее время не для всех патологических механизмов нарушений фертильности у мужчин разработаны корректные диагностические тесты, это значительно снижает прогностическую ценность спермограммы и делает вопрос оценки нарушений характера спермограммы и их влияния на эффективность ВРТ чрезвычайно актуальным. В данном обзоре речь пойдет о развитии и эффективности ВРТ в мире и России, о влиянии неблагоприятных факторов образа жизни на фертильность при лечении бесплодной пары, о значении мужских факторов бесплодия и зависимости влияния показателей спермограммы как на исходы, так и на отдаленные результаты ВРТ.

Тhe literature review is devoted to the most important medical and social problem of modern medicine — the male infertility. Nowadays the assessment and treatment of male infertility can identify a number of problems: the lack of standard tests for assessing fertility, incomplete knowledge of the pathophysiology of infertility, a shortage of specialists in the field of andrology and male infertility, as well as a lack of necessary technical resources. The lack of proven methods of pharmacotherapy can be added to this list. In comparison with the successes in the detection and treatment of female infertility, the diagnosis and therapy of male, especially idiopathic, remain ineffective and are largely empirical in nature. It is difficult to identify at what rates of spermogram the most frequent failures of the ART program occur, to compare the indicators of failures of ART with the parameters of pathozoospermia to reveal the regularity. Not all pathological mechanisms of fertility disorders in men have developed correct diagnostic tests at the present time, this significantly reduces the prognostic value of the spermogram and makes the question of assessing the disturbances in the character of the spermogram and its effect on the effectiveness of ART procedures extremely topical. There will be discussed the development and effectiveness of ART in the world and in Russia, the role of unfavorable lifestyle factors in infertile couples, the role of male infertility factors and the dependence of the effects of spermogram indices on the results of ART.

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The authors declare that there are no conflicts of interest present.