В настоящем обзоре представлены имеющие различные уровни и степени доказательности данные об информировании, проведении обследования и подготовке состоящих в бесплодном браке мужчин к применению вспомогательных репродуктивных технологий. Предложен алгоритм маршрутизации пациентов в процессе подготовки к выполнению программы вспомогательных репродуктивных технологий. Ключевые слова: мужское бесплодие, вспомогательные репродуктивные технологии.

Introduction. Sexually transmitted diseases (STDs) can potentially disrupt male fertility; however, the prevalence data for STDs among men from infertile couples is controversial. Aim. The aim of the study was to estimate the prevalence of STDs among men from infertile couples seeking medical assistance in an assisted reproductive technology clinic. Materials and methods. We retrospectively studied the medical records of 307 men (mean age: 35 ± 15 years) consecutively attending an outpatient reproductive clinic for infertility treatment. Duration of the infertile period varied from 4 to 228 months (mean: 38 ± 12 months). We collected urethral swab specimen to investigate the presence of Neisseria gonorrhoeae, Trichomonas vaginalis, Chlamydia trachomatis, Mycoplasma, and Ureaplasma species in 235 (76.5%), 232 (75.6%), 270 (87.9%), 301 (98.1%), and 300 (97.7%) men, respectively. Blood tests for syphilis, hepatitis B and C, human immunodeficiency virus (HIV), human herpesvirus (HHV), and cytomegalovirus (CMV) were conducted in 229 (74.6%), 224 (73%), 227 (73.9%), 230 (74.9%), 233(75.9%), and 232 (75.6%) men, respectively, and statistical analysis of the data was performed. Results. Remarkably, all tests were negative in 94 (30.6%) men, and no patient had T. vaginalis or C. trachomatis infection. However, N. gonorrhoeae, Mycoplasma, and Ureaplasma were detected in 1 (0.4%), 6 (2.6%), and 14 (4.7%) men, respectively. Syphilis, hepatitis B and C, HIV, HSV, and CMV tests were positive in 1 (0.4%), 2 (0.9%), 6 (2.6%), 1(0.4%), 177 (76%), and 133 (57%) men, respectively. Conclusions. The prevalence of STDs is high among men from infertile couples. Further studies are warranted to investigate the relationship between STDs and male infertility. (For citation: Korneyev IA, Zasseev RD, Shevchuk IG, Pelipejchenko AA. Prevalence of sexually transmitted diseases among men from infertile couples. Urologicheskie vedomosti. 2018;8(2):30-35. doi: 10.17816/uroved8230-35).

Aim of study. To estimate testicular microlithiasis (TM) prevalence in men seeking help for infertility in reproductive medicine center, and generate an algorithm for TM management according to patients choice to perform testicular biopsy or not. Materials and methods. We retrospectively reviewed charts of 143 consecutive adult male patients between 19 and 73 years (mean age 34.6 7.9) seeking help for infertility in International Center for Reproductive Medicine. Gray-scale and color Doppler were used to calculate testicular volume and to study a spectrum of scrotal disorders including testicular microlithiasis. Results. Testicular size varied from 0.5 to 33.3 ml (mean 12.3 5.8 ml), testicular hypoplasia, varicocele, hydrocele and epididymal cysts were detected in 88 (61.5%), 35 (24.5%), 9 (6.3%) and 50 (35%) patients respectively. TM signs were identified in 12 (8.4%) men, including 5 (42%) cases of classic TM and 7 (58%) cases of limited TM; 5 (42%) men had bilateral TM. One 1 (8%) patient with bilateral ТМ had ultrasonic appearance of non-palpable testicular tumor, radical surgical treatment was performed. Patients with TM had smaller testicles, higher prevalence of azoospermia and testicular tumor (p = 0.002, 0.013 and 0.085 respectively). All patients with TM were informed about their risks to harbor testicular cancer and taught self-examination technique. Testicular biopsy was offered to all men with concomitant risk factors for testicular cancer development, however none of the patients agreed. We have consequently developed algorithm for TM management according to patients choice to perform or to avoid testicular biopsy. Conclusion. ТМ is common in infertile men, scrotum ultrasound is indicated to detect it. The suggested algorithm for TM management is aimed towards early testicular cancer detection and successful treatment with fertility potential preservation.

Introduction. Diurnal variability of sperm parameters is controversial and should be considered during medical evaluation and solicitation of sperm donors. Aim: to evaluate diurnal variability of sperm parameters of anonymous sperm donors in reproductive medicine center. Materials and methods. Records of 1253 semen samples analysis of 39 sperm donors (mean age 27.1 ± 3.9 years) were retrospectively studied in reproductive medicine center in Saint Petersburg. Semen analysis was performed according to WHO 2010 recommendations. Diurnal variations of semen volume, sperm concentration, total sperm number, progressive motility and number of progressively motile sperm were analyzed. Results. Mean ejaculate volume, sperm total number and number of progressively motile sperm were higher after 3 p.m. (t = 5.63, p < 0.0001; t = 3.66, p = 0.0003 and t = 1.76, p = 0.078, respectively), while sperm concentration and percent of progressively motile sperm was lower (t = 2.03, p = 0.043 and t = 4.63, p = 0.0003, respectively).The lowest and the highest mean sperm numbers were registered in time slots between 12 a.m.–1 p.m. and 4 p.m.–5 p.m., respectively. Conclusions. The study suggests the diurnal variability of sperm donors’ semen parameters. We might recommend a potential sperm donor preservation to be performed after 3 p.m., preferentially within 4 p.m.–5 p.m. interval.

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