Search for the causes of reproductive system disorders: a research review


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Abstract

The continuous development of assisted reproductive technologies (ART) has led to the fact that all types of male and female infertility have now been overcome; however, the effectiveness of using ART methods remains limited and is approximately 30%. What is the reason for this? The paper reviews the world literature sources available in the databases Scopus, Web of Science, MedLine, Cochrane CENTRAL, Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effectiveness (DARE), EMBASE, Global Health, CyberLeninka, and Russian Science Citation Index (RSCI) for a comprehensive study of the contribution of various factors to the development of reproductive system disorders. It considers the possible role of genetic and immunological causes, abnormal intra-ovarian steroidogenesis and folliculogenesis, leading to oocyte defects and mitochondrial disorders, which can in turn contribute to impaired early embryogenesis. The analyzed findings are promising, but further investigations of the etiopathogenesis of reproductive system disorders are needed to optimize the algorithm for patient examination and treatment. Particular attention is paid to the most demonstrative clinical model of reproductive system disorders, such as infertility of unknown origin, as an investigation object, when the reproductive system appears anatomically and functionally normal; however, conception does not occur. Conclusion: The information on the role of genetic and immunological causes, abnormal intra-ovarian steroidogenesis and folliculogenesis, leading to oocyte defects and mitochondrial disorders, which can in turn promote impaired early embryogenesis is summarized and analyzed. The algorithm for the diagnosis and treatment of patients with infertility of unknown origin, which is currently relevant from a clinical point of view, is given.

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About the authors

Evgeniya V. Kirakosyan

I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University); Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation

Email: evgeniya.kirakosyan@mailru
graduate, Department of Obstetrics, Gynecology, Perinatology and Reproductology

Tatyana A. Nazarenko

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation

Dr. Med. Sci., Professor, Director of the Institute of Reproductive Medicine

Stanislav V. Pavlovich

I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University); Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation

Email: s_pavlovich@oparina4.ru
PhD., Academic Secretary; Professor, Department of Obstetrics, Gynecology, Perinatology and Reproductology

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