Oxidative stress is one of the leading causes of sperm dysfunction. Excessive amounts of reactive oxygen species can damage sperm membranes and disrupt their DNA integrity, which affects not only the likelihood of getting pregnant naturally, but also the clinical outcomes of assisted reproductive technologies and the risk of miscarriage. Sperm cells are extremely vulnerable to oxidative stress, given the limited functional reserve of their antioxidant systems and the DNA repair apparatus. Lifestyle factors, most of which are modifiable, often trigger generation of reactive oxygen species.  Both the lifestyle modification and use of antioxidant dietary supplements are adequate and compatible ways to combat male oxidative stress-associated infertility. The search for other internal and external sources of reactive oxygen species, the identification of the etiology of oxidative stress and treatment of respective diseases are necessary for the successful regulation of redox processes in the male reproductive system in clinical practice, which is required not only to overcome infertility, but also to prevent induced epigenetic disorders in subsequent generations. The article presents the analysis of the molecular mechanisms of male idiopathic infertility. The authors provide an overview of how to prevent oxidative stress as one of the causes of subfebrile fever. The article provides an overview of modern therapeutics, as well as the options for eliminating the consequences of the effect of reactive oxygen species on spermatogenesis and male reproductive system in general.

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Objective: This study aimed to describe a distinct subpopulation of azoospermic patients with isolated elevation of follicle-stimulating hormone (iFSH) and poor outcomes of microdissection testicular sperm extraction (microTESE).Methods: A retrospective analysis of microTESE outcomes was conducted among 565 patients with non-obstructive azoospermia (NOA). Testicular pathology was assessed by the dominant histological pattern and Bergmann-Kliesch score (BKS). Descriptive statistics were presented for the iFSH subgroup. Inhibin B levels, the sperm retrieval rate (SRR), and BKS were compared in iFSH patients and other NOA patients.Results: The overall SRR was 33.3% per microTESE attempt. The median BKS was 0.6 (interquartile range, 0–2). Of all NOA patients, 132 had iFSH, and microTESE was successful only in 11 of those cases, with an SRR of 8.3%, while the total SRR in other NOA patients was 38.1% (p<0.001). iFSH had a sensitivity of 32.1% (95% confidence interval [CI], 27.4%–36.8%) and specificity of 94.1% (95% CI, 90.8–97.4%) as a predictor of negative microTESE outcomes.Conclusion: Patients with iFSH may harbor a distinct testicular phenotype with total loss of the germ cell population and poor outcomes of surgical sperm retrieval.

Introduction. There’re some pathological mechanisms of male fertility disorders that still don’t have proper diagnostic tests. This significantly decreases diagnostic value of a spermogram and makes the problem of evaluation of the characteristics of spermogram changes and their effects on the effectiveness of assisted reproductive technologies (ART) a pressing problem.The study objectiveis to identify the correlation between effectiveness of ART programs and the characteristics of spermogram changes, in particular sperm concentration, motility, and morphology Materials and methods. At the V.I. Kulakov Research Center for Obstetrics, Gynecology and Perinatology in the period from December of 2012 to December of 2016, 10,042 married couples who underwent treatment using ART (2221 – in vitro insemination (IVF), 7821 – IVF with intracytoplasmic sperm injection) were examined.Results. In patients after IVF, the frequency of live births significantly depended on sperm concentration: 28.6 % for concentration above 5 mil/ml and 51.5 % for concentration above 15 mil/ml (p <0.0001). No significant difference was observed for the dependence of the frequency of live births on the number of progressive-motile sperm (grade А): 38.2 % for <5 % and 57.7 % for >15 % (p = 0.11), or on the number of spermatozoa with normal morphology: 50 % for ≥4 % and 45.5 % for <4 % (p = 0,23). In patients after IVF with intracytoplasmic sperm injection, the concentration of spermatozoa, number of progressive-motile sperm (grade А), and number of spermatozoa with normal morphology didn’t affect the frequency of live births in a statistically significant way.Conclusion. Sperm concentration, motility, and morphology can affect the frequency of live births in the IVF program, but statistically significant correlation was observed only for sperm concentration. After IVF with intracytoplasmic sperm injection, only sperm morphology affects the frequency of live births, but not in a statistically significant way.

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