Recurrent miscarriage: What depends on a male partner?
Objective. To carry out a systematic analysis of the data available in the current literature on the role of a man in recurrent miscarriage (RM) and reproductive losses in his spouse. Material and methods. The review included data of foreign and Russian papers on this topic which were published in the last 10 years and found in Pubmed database. Results. The paper describes the negative impact of higher sperm DNA fragmentation on the course of pregnancy, especially in its f irst trimester, on the occurrence of RM or non-developing pregnancy, and on the effectiveness of assisted reproductive technology (ART) programs. It considers the etiology and pathogenesis of sperm DNA damage. The positive impact of modifying unhealthy lifestyle factors, the role of varicocelectomy and antioxidant therapy, and recent advances in ART are presented. There is evidence that various disorders (translocations) of normal male karyotype are implicated in pathogenesis of pregnancy loss. The paper considers the role of urological surgery and preimplantation genetic diagnosis in solving this problem. Conclusion. There is a need for further investigations to evaluate the impact of a male partner on pregnancy losses, ART outcomes and healthy birth rates. New ways are proposed to solve the problems of RM in a couple, by correcting abnormalities in men via sperm DNA fragmentation reduction.