A comprehensive analysis of the problem of male infertility: from molecular mechanisms to clinical application

Abstract

The article is devoted to the analysis of data on the mechanisms of male infertility development with an emphasis on such molecular mechanisms as oxidative stress, sperm DNA damage, epigenetic disorders and the role of microRNA (miRNA) in the regulation of spermatogenesis. It is reported that the male factor accounts for up to 50% of infertility cases. Traditional diagnostic methods, including spermogram examination, have limited prognostic value, which stimulates the search for new biomarkers, such as the presence of signs of DNA fragmentation and characterization of miRNA expression profiles. Particular attention is paid to the role of miRNA (for example, miR-34b / c, miR-449a / b / c, miR-135a), which regulate key processes of spermatogenesis and can serve as diagnostic markers of its abnormalities. Data on their association with various forms of pathology, including azoospermia and asthenozoospermia are provided. Recommendations are proposed for the inclusion of miRNA analysis in clinical practice to improve the quality of diagnostics and predict the effectiveness of assisted reproductive technologies (ART). The need for further research to develop a personalized approach to the treatment of male infertility is argued, which can significantly improve the effectiveness of medical care and improve demographic indicators.