РОЛЬ МУЖСКОГО ФАКТОРА БЕСПЛОДИЯ В ПРОГРАММЕ ВСПОМОГАТЕЛЬНЫХ РЕПРОДУКТИВНЫХ ТЕХНОЛОГИЙ (ОБЗОР ЛИТЕРАТУРЫ)

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.

мужское бесплодие, вспомогательные репродуктивные технологии, спермограмма

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