Vorobets M. Clinical and pathogenetic markers of infertility development in men with azoospermia

The objects - obstructive and non-obstructive forms of azoospermia in men; clinical symptoms, diagnosis, histology of testicular biopsies, hormonal, biochemical and cytogenetic parameters; the purpose - elucidation of pathogenetic features of infertility in men with azoospermia by studying instrumental, histological, biochemical and genetic parameters; methods - сlinical and anamnestic, general clinical, instrumental (ultrasound, sonoelastography), histological (examination of testicular biopsies), biochemical ( activity of arginase-NO-synthase enzymes, glutathione antioxidant and Ca2+-dependent ATP-hydrolase systems, cytogenetic and statistical analysis; results - the pathogenetic features of infertile men with seсretory-endocrine and excretory-obstructive forms of azoospermia were clarified by analyzing disorders of hemodynamics of the testes, histological examination of the seminal tubules, hormonal, biochemical and cytogenetic indicators of fertility potential. For the first time, a decrease in the regulatory index of restored glutathione in the seminal plasma of men with non-obstructive azoospermia has been shown, which indicates a decrease in the total power of the antioxidant system. Extended ideas about the pathogenesis of various forms of azoospermia and new data relevant to the mechanisms of fertility disorders of men with azoospermia were obtained. Based on histological analysis of testicular tissue of patients with non-obstructive azoospermia, it is shown that in all samples there are changes in the tortuous seminal tubules and their diameter is reduced (hypoplasia) relative to normal, the walls of the seminal tubules are thickened, the basement membrane is markedly fibrous, and spermatogenesis is either completely absent or stopped at the stage of spermatogonia. High correlations have been established between testicular volume and serum concentrations of inhibin B and FSH and arginase and inducible NO-synthase activities, which indicates the pathogenetic significance of these indicators; introduced - in the scientific and educational process of health care institutions and Danylo Halytskyi Lviv National Medical University; branch - medicine.