Применение рекомбинантного ФСГ в лечении бесплодия, ассоциированного с высоким уровнем фрагментации ДНК сперматозоидов

Применение рекомбинантного ФСГ в лечении бесплодия, ассоциированного с высоким уровнем фрагментации ДНК сперматозоидов

Автор: Олефир Ю.В., Монаков Д.М., Родионов М.А., Живулько А.Р., Виноградов И.В., Попов Д.М.

Журнал: Экспериментальная и клиническая урология @ecuro

Рубрика: Андрология

Статья в выпуске: 2 т.16, 2023 года.

Бесплатный доступ

Введение. Мужское бесплодие, обусловленное высоким уровнем фрагментации ДНК сперматозоидов, остается одной из значимых проблем репродуктивной медицины. Одним из методов его преодоления может быть применение препаратов рекомбинантного фолликулостимулирующего гормона (ФСГ), однако результаты исследований по данному вопросу неоднозначны. Цель настоящего обзора литературы - систематизация публикаций по данной проблематике. Материалы и методы. Проведены поиск, анализ и систематизация публикаций в базах данных PubMed, eLibrary.ru, Clinicaltrials.gov с использованием ключевых слов «мужское бесплодие» («male infertility»), «фрагментация ДНК сперматозоидов» («sperm DNA fragmentation»), «лечение» («treatment»), «фолликуллостимулирующий гормон» («follicle stimutating hormone»), «ФСГ» («FSH»). Отобрано 76 публикаций, которые были включены в настоящий обзор. Результаты и обсуждение. Целостность генетического материала сперматозоида - одно из обязательных условий формирования нормального эмбриона. Его повреждение реализуется двумя основными путями - индукцией апоптоза и прямым повреждением ДНК активными формами кислорода. ФСГ стимулирует сперматогенез, а также препятствует индукции апоптоза сперматозоидов посредством активации протеинкиназы B/AKT. Также ФСГ регулирует упаковку хроматина и повышает способность сперматозоидов к связыванию с гиалуроновой кислотой. Его применение у бесплодных мужчин приводило к улучшению морфологических показателей спермограммы, увеличению подвижности сперматозоидов, снижению уровня фрагментации ДНК сперматозоидов, однако полученные данные трудно сопоставимы из-за гетерогенности групп пациентов, включенных в исследование, отсутствия стандартизации методов исследования уровня фрагментации ДНК сперматозоидов и использования различных пороговых значений этого показателя. Выводы. Терапия препаратами рекомбинантного ФСГ является одним из перспективных методов преодоления бесплодия у пациентов с высоким уровнем фрагментации ДНК сперматозоидов. Гетерогенность опубликованных исследований не позволяет сделать однозначных выводов относительно ее влияния на целостность генетического материала сперматозоидов. В будущих исследованиях необходимо использование строгих критериев включения, таких как пороговые значения уровня фрагментации ДНК сперматозоидов и результаты фармако-генетического исследования.

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Мужское бесплодие, фрагментация днк сперматозоидов, лечение, фолликулостимулирующий гормон, фсг

Короткий адрес: https://sciup.org/142239009

IDR: 142239009   |   DOI: 10.29188/2222-8543-2023-16-2-99-105

Список литературы Применение рекомбинантного ФСГ в лечении бесплодия, ассоциированного с высоким уровнем фрагментации ДНК сперматозоидов

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