Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciencesВестник Российской академии медицинских наук0869-60472414-3545"Paediatrician" Publishers LLC55110.15690/vramn.v70.i5.1445SCIENTIFIC REPORTSНАУЧНЫЕ СООБЩЕНИЯCauses and Factors of Male InfertilityПричины и факторы риска мужской инфертильностиKolesnikovaL. I.КолесниковаЛ. И.
Russian Federation

доктор медицинских наук, профессор, член-корреспондент РАН, научный руководитель НЦ ПЗСРЧ Адрес: 664003, Иркутск, ул. Тимирязева, д. 16, тел.: +7 (3952) 20-76-36

iphr@sbamsr.irk.ruKolesnikovS. I.КолесниковС. И.
Russian Federation

академик РАН, главный научный сотрудник НЦ ПЗСРЧ Адрес: 664003, Иркутск, ул. Тимирязева, д. 16, тел.: +7 (3952) 20-76-36

iphr@sbamsr.irk.ruKurashovaN. A.КурашоваН. А.
Russian Federation

кандидат биологических наук, научный сотрудник лаборатории патофизиологии репродукции НЦ ПЗСРЧ Адрес: 664003, Иркутск, ул. Тимирязева, д. 16, тел.: +7 (3952) 20-76-36

nakurashova@yandex.ruBairovaT. A.БаироваТ. А.
Russian Federation

доктор медицинских наук, заведующая лабораторией персонализированной медицины НЦ ПЗСРЧ Адрес: 664003, Иркутск, ул. Тимирязева, д. 16, тел.: +7 (3952) 20-76-36

iphr@sbamsr.irk.ruScientifi c Centre for Family Health and Human Reproduction Problems, Irkutsk, Russian FederationНаучный центр проблем здоровья семьи и репродукции человека, Иркутск, Российская Федерация031220157055795840312201503122015Copyright ©; 2015, "Paediatrician" Publishers LLCCopyright ©; 2015, Издательство "Педиатръ"2015"Paediatrician" Publishers LLCИздательство "Педиатръ"https://vestnikramn.spr-journal.ru/jour/about/submissionshttps://vestnikramn.spr-journal.ru/jour/article/view/551

The preservation of reproductive health of the population is an important factor of demographic policy of the state. According to some authors from 14 to 30% of couples of reproductive age suffer from infertility, male factor in such marriages is detected in more than half of the cases. As you know, in recent years there has been a significant deterioration in the main indicators of reproductive function of men. Increased the number of andrological diseases, morphological disorders of the male reproductive system, almost halved the production of sperm in men of reproductive age. The reason probably lies behind a whole range of stress factors, such as medical ignorance, uncontrolled and inappropriate use of medication, metabolic disturbances, lack of vitamins and minerals, the impact of industrial pollutants, as well as the growth of addictive disorders (alcoholism, smoking and drug addiction). The forms of infertility differ according to its etiology and severity from minor changes to complete spermatogenesis dysfunction of the gonads, and can also occur due to genetic disorders. The lack of analysis of the relationship between clinical and genetic-biochemical components in men with infertility makes it impossible to understand the pathogenesis of infertility and to assess the risks of male infertility. High level of current medicine does not always guarantee an identification of the cause of male infertility. The article analyzes data from the review of specialized literature on the diagnosis and etiopathogenesis of male infertility. Frequency and clinical signs of pathology of the male reproductive system depend on the combinatorial effects of environmental influences, manifested most often in mutually reinforcing effect. A combination of several, seemed to be imperceptible factors makes the risk of development of male reproductive pathology very high. This situation compels specialists to conduct comprehensive studies on the men reproductive potential.

Сохранение репродуктивного здоровья населения — важный фактор демографической политики государства. По данным ряда авторов, от 14 до 30% супружеских пар репродуктивного возраста страдают бесплодием, при этом мужской фактор в таких браках выявляется более чем в 1/2 случаев. В последние годы отмечено значительное ухудшение состояния основных показателей репродуктивной функции мужчин. Увеличилось число андрологических заболеваний, морфологических нарушений мужской репродуктивной системы, практически вдвое снизилась продукция сперматозоидов у мужчин репродуктивного возраста. Причина, вероятно, скрывается за целым комплексом стрессогенных факторов, таких как медицинская неосведомленность, бесконтрольное и неадекватное применение лекарственных средств, метаболические нарушения, недостаток витаминов и микроэлементов, влияние промышленных поллютантов, а также рост числа аддиктивных нарушений (алкоголизм, курение и наркомания). Разные по своей этиологии и степени тяжести формы бесплодия, от незначительных изменений сперматогенеза до полной дисфункции гонад, также могут возникнуть из-за генетических нарушений. Отсутствие анализа взаимосвязи клинической и генетико-биохимической компоненты у мужчин с бесплодием не позволяет подойти к пониманию патогенетики бесплодия и оценке риска развития мужской инфертильности. Высокий уровень развития современной медицины не всегда гарантирует истинное установление причин мужского бесплодия. В статье проанализированы результаты обзора специализированной литературы по вопросам диагностики и этиопатогенеза инфертильности мужчин. Частота и клинические признаки патологии мужской репродуктивной системы зависят от комбинаторности воздействия средовых влияний, проявляющихся чаще всего во взаимоусиливающемся эффекте. Сочетание нескольких, даже слабых, но однонаправленно действующих факторов делает риск развития мужской репродуктивной патологии очень высоким. Критичность ситуации побуждает специалистов проводить дополнительные комплексные исследования репродуктивного потенциала мужского населения.

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