Spivak Z. Infertility in men with hypothyroidism, optimization of its therapy.

The purpose of the research is to improve the efficiency of the treatment of spermatogenesis in infertile men with hypothyroidism, on the basis of determination of features of change of the functional state of the pituitary-gonad. The object of the study is the process of disorders of spermatogenesis in men with hypothyroidism. Methods of research: general (history taking, physical examination) clinical, clinical-laboratory, morphological, biochemical, immunoenzymatic, statistical. Scientific novelty of got results. Obtained while working data, greatly extend the idea concerning changes of the functional state of the pituitary- gonad in infertile men with the thyroid hypofunction. It was established that a violation of function of spermatogenic of testicular in men with primary manifest and subclinical hypothyroidism, may subsist as on the background of an androgen deficit as in the case of its absence. It was determined, that the formation of testicular dysfunction in infertility men with manifest and subclinical hypothyroidism, in most cases exists as the type of normogonadotrophic hypogonadism. It is found, that the substantial significance in the development of androgen deficit stage in infertile men, ill with primary manifest hypothyroidism, has the intensification of secretion of prolactin. It is proved that a significant increase of antibody level to thyroid peroxidase in infertile men with autoimmune thyroiditis promotes the development of phenomenon of spermatozoids agglutination, that leads to the violation of their mobility. It is determined, that the excess weight and obesity, as well as increase of cholesterol level in blood exacerbates disfunctional changes in the system of pituitary-gonads in infertile men with thyroid hypofunction. It is proved, that the main factor in recovery of incretory and spermatogenic function of spermary, in infertility in men with manifest and subclinical hypothyroidism, is the normalization of thyroid status. The combination of these provisions provides the possible to justify theoretically approaches to therapy of pathospermia in men with thyroid hypofunction. The practical significance of got results. The realised research became the basis for improvement of pathospermia therapy in men with manifest and subclinical hypothyroidism, and also of hypofertile on the background of autoimmune thyroiditis in euthyroid stage. It is proved, that for improvement of fertilization ability of sperm in patients with such tyreopathy the relevant will be the usage of antioxidant-immunocorrecting therapy. Therapeutic methods of disorders of the reproductive function of men with hypothyroidism thyroid gland, as well as autoimmune thyroiditis in euthyroid stage reflected in the news letter "The therapy of infertility in men having thyreopaties."