Современные аспекты патогенеза, диагностики и лечения мужского бесплодия
Урология
Дата публикации: декабря 20, 2014
Ключевые слова
патогенез
диагностика
лечение
мужское бесплодие
диагностика
лечение
мужское бесплодие
Как цитировать
Гамидов С., Овчинников Р., Щербаков Д., Тхагапсоева Р. Современные аспекты патогенеза, диагностики и лечения мужского бесплодия // Кремлевская медицина. Клинический вестник. 2014. Т. № 2. С. 26-30.
Аннотация
Не менее чем в половине случаев бесплодие пары свя-зано с нарушениями сперматогенеза. Наиболее частымипричинами развития мужского бесплодия являются ва-рикоцеле, воспалительные заболевания мужской поло-вой системы, гормональные нарушения и крипторхизм. Взначительном числе случаев установить причину мужско-го бесплодия не удаётся. Лечение мужского бесплодия вомногих случаях носит эмпирический характер. На сегод-няшний день общепризнанных методов медикаментозно-го лечения идиопатической формы мужского бесплодияне существует. Применение вспомогательных репродук-тивных технологий является высокоэффективным мето-дом лечения бесплодия, характеризуясь при этом высокойстоимостью и инвазивностью.Ключевые слова: патогенез, диагностика, лечение,мужское бесплодие.SummaryCurrent aspects of pathogenesis, diagnostic and treatment ofmen's infertilityS.I. Gamidov, R.I. Ovchinnikov, D.V. Sherbakov,R.A. ThagapsoyevaPirogov’s Russian State Medical University, Moscow«Сlinical hospital» of the Department of affairs managementof President of Russian Federation, MoscowSummarySurvey of scientific publications about the pathogenesis,diagnostic and treatment of men's infertility.Key words: pathogenesis, diagnostics, treatment, men'sinfertility.Литература
1. Жиборев Б.Н. Заболевания органов половой си-
стемы в патогенезе нарушений репродуктивного здоровья
мужчины // Урология. 2008;3: 62–67.
2. Aitken RJ, Krausz C. Oxidative stress, DNA damage
and the Y chromosome. Reproduction 2001; 122: 497–506.
3. Bohring C, Krause W. Immune infertility: towards a
better understanding of sperm (auto)-immunity. The value of
proteomic analysis. Hum Reprod 2003; 18: 915–924.
4. Cavallini G. Male idiopathic oligoasthenoteratozoospermia.
Asian J Androl 2006; 8: 143–157.
5. Chehval MJ, Mehan DJ. Chorionic gonadotropins in
the treatment of the subfertile male. Fertil Steril. 1979; 31: 666–
668.
6. Chiu WW, Chamley LW. Use of antisperm antibodies
in differential display Western blotting to identify sperm proteins
important in fertility. Hum Reprod 2002; 17: 984–989.
7. Cunningham KA, Beagley KW. Male genital tract
chlamydial infection: implications for pathology and infertility.
Biol Reprod. 2008; 79: 180–189.
8. Evers JL, Collins JA. Surgery or embolisation for
varicocele in subfertile men. Cochrane Database Syst Rev
2004;(3): CD000479.
9. Evers JLH, Collins JA. Assessment of efficacy of
varicocele repair for male subfertility: a systematic review. Lancet
2003; 361: 1849–1852.
10. Ficarro V, Cerruto MA, Liguori G, et al. Treatment of
varicocele in subfertile men: the Cochrane review – a contrary
opinion. Eur Urol. 29: 258–263.
11. Gregoriou O, Vitoratos N, Papadias C, et al. Treatment
of idiopathic oligozoospermia with an alpha-blocker: a placebocontrolled
double-blind trial. Int J Fertil Womens Med. 1997; 42:
301–305.
12. Kessopoulou E, Powers HJ, Sharma KK, et al. A
double-blind randomized placebo cross-over controlled trial
using the antioxidant vitamin E to treat reactive oxygen species
associated male infertility. Fertil Steril. 1995; 64: 825–831.
13. Koide SS, Wang L, Kamada M. Antisperm antibodies
associated with infertility: properties and encoding genes of
target antigens. Proc Soc Exp Biol Med 2000; 224: 123–132.
14. Kruger TF, Acosta AA, Simmons KF, et al. Predictive
value of abnormal sperm morphology in in vitro fertilization.
Fertil Steril 1988;49:112–117.
15. Kumar R, Gautam G, Gupta MP. Drug Therapy for
Idiopathic Male Infertility: Rationale Versus Evidence. J Urol.
2006; 176: 1307–1312.
16. Laven JS, Haans LC, Mali WP, et al. Effects of
varicocele treatment in adolescents: a randomised study. Fertil
Steril 1992; 58: 756–762.
17. Lenzi A, Culasso F, Gandini L, et al. Placebocontrolled,
double blind, cross-over trial of glutathione therapy
in male infertility. Hum Reprod, 1993; 8: 1657–1662.
18. Lenzi A, Sgro P, Salacone P, et al. A placebo-controlled
double-blind randomized trial of the use of combined l-carnitine
and l-acetyl-carnitine treatment in men with asthenozoospermia.
Fertil Steril. 2004; 81: 1578–1574.
19. McLachlan RI, Wreford NG, O’Donnel L, De
Krester DM, Robertson DM. The endocrine regulation of
spermatogenesis: independent roles for testosterone and FSH. J
Endocrinol 1996; 148: 1–9.
20. Mieusset R, Bujan L, Massat G, et al. Clinical and
biological characteristics of infertile men with a history of
cryptorchidism. Hum Reprod. 1995; 10: 613–619.
21. Ness RB, Markovic N, Carlson CL, Coughlin MT. Do
men become infertile after having sexually transmitted urethritis?
An epidemiologic examination. Fertil Steril. 1997; 68: 205–213.
22. Ochendorf FR. Infections in the male genital tract and
reactive oxygen species. Hum Reprod Update 1999; 5: 399–420.
23. Ochsendorf FR, Buhl R, Bastlein A, Beschmann H.
Glutathione in spermatozoa and seminal plasma of infertile
men. Hum Reprod. 1998; 13: 353–359.
24. Ombelet W, Bosmans E, Janssen M, et al. Semen
parameters in a fertile versus subfertile population: a need for
change in the interpretation of semen testing. Hum Reprod.
1997; 12: 987–993.
25. Palermo G, Alikani M, Bertoli M, et al. Oolemma
characteristics in relation to survival and fertilization patterns
of oocytes treated by intracytoplasmic sperm injection. Human
Reproduction 1996; 11: 172–176.
26. Purvis K, Christiansen E. Male infertility: current
concepts. Ann Med. 1992; 24: 259–272.
27. Rolf C, Cooper TG, Yeung CH, Nieschlag E.
Antioxidant treatment of patients with asthenozoospermia or
moderate oligoasthenozoospermia with high-dose vitamin C
and vitamin E: a randomized, placebo-controlled, doubleblind
study. Hum Reprod. 1999; 14: 1028–1033.
28. Sadeghi-Nejad H, Oates RD. The Y chromosome and
male infertility. Curr Opin Urol. 2008; 18: 628–632.
29. Said TM, Paasch U, Glander HJ, Agarwal A. Role of
capases in male infertility. Hum Reprod Update 2004; 10: 39–51.
30. Sanocka D, Kurpisz M. Reactive oxygen species and
sperm cells. Reprod Biol Endocrinol 2004; 2: 12–9.
31. Shang XJ, Huang YF, Xiong CL, et al. Uraplasma
urealyticum infection and apoptosis of spermatogenetic cells.
Asian J Androl 1999; 1: 127–129.
32. Siddiq FM, Sigman M. A new look at the medical management
of infertility. Urol Clin North Am. 2002; 29: 949–963.
33. Sinha Hikim AP, Swerdloff RS. Hormonal and genetic
control of germ cells apoptosis in the testis. Rev Reprod 1999; 4:
38–47.
34. Tarlatzis BC, Bili H. Intracytoplasmic sperm injection.
Survey of world results. Annals of the New York Academy of
Sciences. 2000; 900: 336–344.
35. Vandekerckhove P, Lilford R, Vail A, Hughes E.
Androgens versus placebo or no treatment for idiopathic
oligo/asthenospermia. Cochrane Database Syst Rev. 2000; 2:
CD000150.
36. Vandekerckhove P, Lilford R, Vail A, Hughes E.
Clomiphene or tamoxifen for idiopathic oligo/asthenospermia.
Cochrane Database Syst Rev. 2000; 2: CD000151.
37. Verstoppen GR, Steeno OP. Varicocele and the
pathogenesis of the associated subfertility: a review of the various
theories. II. Results of surgery. Andrologia 1977; 9: 293–305.
38. Wong WY, Thomas CMG, Merkus JM, et al. Male
factor subfertility: possible causes and the impact of nutritional
factors. Fertil Steril. 2000; 73: 435–442.
39. World Health Organization. Laboratory manual for
the examination of human semen and semen-cervical mucus
interaction. 3rd ed. New York: Cambridge University Press,
1993: 43–44.
40. World Health Organization. The influence of varicocele
on parameters of fertility in a large group of men presenting to
infertility clinics. Fertil Steril 1992; 57: 1289 –1293.
стемы в патогенезе нарушений репродуктивного здоровья
мужчины // Урология. 2008;3: 62–67.
2. Aitken RJ, Krausz C. Oxidative stress, DNA damage
and the Y chromosome. Reproduction 2001; 122: 497–506.
3. Bohring C, Krause W. Immune infertility: towards a
better understanding of sperm (auto)-immunity. The value of
proteomic analysis. Hum Reprod 2003; 18: 915–924.
4. Cavallini G. Male idiopathic oligoasthenoteratozoospermia.
Asian J Androl 2006; 8: 143–157.
5. Chehval MJ, Mehan DJ. Chorionic gonadotropins in
the treatment of the subfertile male. Fertil Steril. 1979; 31: 666–
668.
6. Chiu WW, Chamley LW. Use of antisperm antibodies
in differential display Western blotting to identify sperm proteins
important in fertility. Hum Reprod 2002; 17: 984–989.
7. Cunningham KA, Beagley KW. Male genital tract
chlamydial infection: implications for pathology and infertility.
Biol Reprod. 2008; 79: 180–189.
8. Evers JL, Collins JA. Surgery or embolisation for
varicocele in subfertile men. Cochrane Database Syst Rev
2004;(3): CD000479.
9. Evers JLH, Collins JA. Assessment of efficacy of
varicocele repair for male subfertility: a systematic review. Lancet
2003; 361: 1849–1852.
10. Ficarro V, Cerruto MA, Liguori G, et al. Treatment of
varicocele in subfertile men: the Cochrane review – a contrary
opinion. Eur Urol. 29: 258–263.
11. Gregoriou O, Vitoratos N, Papadias C, et al. Treatment
of idiopathic oligozoospermia with an alpha-blocker: a placebocontrolled
double-blind trial. Int J Fertil Womens Med. 1997; 42:
301–305.
12. Kessopoulou E, Powers HJ, Sharma KK, et al. A
double-blind randomized placebo cross-over controlled trial
using the antioxidant vitamin E to treat reactive oxygen species
associated male infertility. Fertil Steril. 1995; 64: 825–831.
13. Koide SS, Wang L, Kamada M. Antisperm antibodies
associated with infertility: properties and encoding genes of
target antigens. Proc Soc Exp Biol Med 2000; 224: 123–132.
14. Kruger TF, Acosta AA, Simmons KF, et al. Predictive
value of abnormal sperm morphology in in vitro fertilization.
Fertil Steril 1988;49:112–117.
15. Kumar R, Gautam G, Gupta MP. Drug Therapy for
Idiopathic Male Infertility: Rationale Versus Evidence. J Urol.
2006; 176: 1307–1312.
16. Laven JS, Haans LC, Mali WP, et al. Effects of
varicocele treatment in adolescents: a randomised study. Fertil
Steril 1992; 58: 756–762.
17. Lenzi A, Culasso F, Gandini L, et al. Placebocontrolled,
double blind, cross-over trial of glutathione therapy
in male infertility. Hum Reprod, 1993; 8: 1657–1662.
18. Lenzi A, Sgro P, Salacone P, et al. A placebo-controlled
double-blind randomized trial of the use of combined l-carnitine
and l-acetyl-carnitine treatment in men with asthenozoospermia.
Fertil Steril. 2004; 81: 1578–1574.
19. McLachlan RI, Wreford NG, O’Donnel L, De
Krester DM, Robertson DM. The endocrine regulation of
spermatogenesis: independent roles for testosterone and FSH. J
Endocrinol 1996; 148: 1–9.
20. Mieusset R, Bujan L, Massat G, et al. Clinical and
biological characteristics of infertile men with a history of
cryptorchidism. Hum Reprod. 1995; 10: 613–619.
21. Ness RB, Markovic N, Carlson CL, Coughlin MT. Do
men become infertile after having sexually transmitted urethritis?
An epidemiologic examination. Fertil Steril. 1997; 68: 205–213.
22. Ochendorf FR. Infections in the male genital tract and
reactive oxygen species. Hum Reprod Update 1999; 5: 399–420.
23. Ochsendorf FR, Buhl R, Bastlein A, Beschmann H.
Glutathione in spermatozoa and seminal plasma of infertile
men. Hum Reprod. 1998; 13: 353–359.
24. Ombelet W, Bosmans E, Janssen M, et al. Semen
parameters in a fertile versus subfertile population: a need for
change in the interpretation of semen testing. Hum Reprod.
1997; 12: 987–993.
25. Palermo G, Alikani M, Bertoli M, et al. Oolemma
characteristics in relation to survival and fertilization patterns
of oocytes treated by intracytoplasmic sperm injection. Human
Reproduction 1996; 11: 172–176.
26. Purvis K, Christiansen E. Male infertility: current
concepts. Ann Med. 1992; 24: 259–272.
27. Rolf C, Cooper TG, Yeung CH, Nieschlag E.
Antioxidant treatment of patients with asthenozoospermia or
moderate oligoasthenozoospermia with high-dose vitamin C
and vitamin E: a randomized, placebo-controlled, doubleblind
study. Hum Reprod. 1999; 14: 1028–1033.
28. Sadeghi-Nejad H, Oates RD. The Y chromosome and
male infertility. Curr Opin Urol. 2008; 18: 628–632.
29. Said TM, Paasch U, Glander HJ, Agarwal A. Role of
capases in male infertility. Hum Reprod Update 2004; 10: 39–51.
30. Sanocka D, Kurpisz M. Reactive oxygen species and
sperm cells. Reprod Biol Endocrinol 2004; 2: 12–9.
31. Shang XJ, Huang YF, Xiong CL, et al. Uraplasma
urealyticum infection and apoptosis of spermatogenetic cells.
Asian J Androl 1999; 1: 127–129.
32. Siddiq FM, Sigman M. A new look at the medical management
of infertility. Urol Clin North Am. 2002; 29: 949–963.
33. Sinha Hikim AP, Swerdloff RS. Hormonal and genetic
control of germ cells apoptosis in the testis. Rev Reprod 1999; 4:
38–47.
34. Tarlatzis BC, Bili H. Intracytoplasmic sperm injection.
Survey of world results. Annals of the New York Academy of
Sciences. 2000; 900: 336–344.
35. Vandekerckhove P, Lilford R, Vail A, Hughes E.
Androgens versus placebo or no treatment for idiopathic
oligo/asthenospermia. Cochrane Database Syst Rev. 2000; 2:
CD000150.
36. Vandekerckhove P, Lilford R, Vail A, Hughes E.
Clomiphene or tamoxifen for idiopathic oligo/asthenospermia.
Cochrane Database Syst Rev. 2000; 2: CD000151.
37. Verstoppen GR, Steeno OP. Varicocele and the
pathogenesis of the associated subfertility: a review of the various
theories. II. Results of surgery. Andrologia 1977; 9: 293–305.
38. Wong WY, Thomas CMG, Merkus JM, et al. Male
factor subfertility: possible causes and the impact of nutritional
factors. Fertil Steril. 2000; 73: 435–442.
39. World Health Organization. Laboratory manual for
the examination of human semen and semen-cervical mucus
interaction. 3rd ed. New York: Cambridge University Press,
1993: 43–44.
40. World Health Organization. The influence of varicocele
on parameters of fertility in a large group of men presenting to
infertility clinics. Fertil Steril 1992; 57: 1289 –1293.