[Clinical guidelines for male infertility: controversial issues and the need to reach interdisciplinary consensus].

A review of controversial issues about the terminology on male infertility and reproductive function, which is currently used, as well as proposals for updating clinical guidelines for the diagnosis and treatment of male infertility and men in infertile couples are presented in the article. An algorithm is described, the elements of which ensure referral of patients based on the possibility and timing of restoration of reproductive function, taking into account the reproductive health of a woman, as well as increasing the likelihood of successful treatment aimed at the birth of a healthy child.

[The efficiency of ART methods for treatment of male infertility in men of age 40 years and older with obstructive azoospermia].

AIM: to evaluate the efficacy of ART methods to treat infertility in men with obstructive azoospermia. MATERIALS AND METHODS: The results of treatment of infertile couples using ART methods during the period from 2009 to 2017 were analyzed. A total of 18 married couples with obstructive azoospermia in men were included in the main group. The control group consisted of 59 married couples in which men had spermatozoa in the ejaculate. Both groups were comparable in age, concomitant gynecological pathology in female partner, protocols of superovulation, fertilization method, days of transfer and the number of transferred embryos into the uterine cavity. The results were evaluated by pregnancy rate (according to the results of determining the level of the -subunit of human chorionic gonadotropin), clinical pregnancy rate (according to the results of the first ultrasound), the number of birth and the number of living children. RESULTS: Pregnancy rate in the main group was 55.6%, compared to 35.6% in the control group (2 with Yeats correction = 1531, p=0.217), while clinical pregnancy rate was 44.4% and 32.2%, respectively (2with Yeats correction = 0.450, p=0.503). In the main group, there were 6 births and 8 children were born (4 with one fetus and 2 twin). In the control group, there were 14 births (2 with Yeats correction=0.168, p=0.683 in comparison with the main group) and 19 children were born (12 one fetus, 2 twins, 1 triplets). The high rates obtained in the main group can be explained by the fact that the obstructive azoospermia doesnt have such a pronounced negative influence on spermatozoa as a non-obstructive azoospermia, and, possibly, as severe oligozoospermia. CONCLUSION: Our data have convincingly established the efficiency of testicular biopsy for the treatment of infertility in men with azoospermia. In addition, spermatozoa obtained from these patients, are suitable for fertilization.