[Deterioration of male reproductive function: methods and algorithms of etiopathogenetic and empirical treatment of...

In half of the cases, a decrease in the quantity and/or quality of spermatozoa is the cause of infertility. The pathogenesis of such disorders is multifactorial, often unknown, and data on the treatment efficiency are still contradictory. Based on the recent high-level evidences (randomized studies and meta-analyses), the real clinical efficiency of various surgical and conservative treatment methods for the main clinical forms of male reproductive dysfunction, including hypo- and hypergonadotropic hypogonadism, secretory and obstructive azoospermia, retrograde ejaculation and anejaculation, pathospermia associated with varicocele, and idiopathic forms, is analyzed. An algorithm for managing patients with these disorders is proposed, which can be convenient in the routine practice of a urologists regardless of the level of equipment of a healthcare facility.