In article on the basis of modern literary data and results of own clinical researches one of the major system pathogenetic factors sperm oxidative stress at male infertility – Insulin Resistance – is considered. Development and progressing of Insulin Resistance mechanisms are closely connected with obesity and androgen deficiency which make the proved negative impact on a man's reproduction. The Insulin Resistance role in male infertility Pathogenesis is shown, and also own point of view on conducting the given patients, allowing essentially to optimise modern approaches to diagnostics and treatment of male infertility, is presented. Today the basic problem consists in dissociation of doctors of various specialities in process of aethiological diagnostics of the reasons of men’s reproductive dysorders, therefore many important and curable factors of infertility Pathogenesis remain not distinguished that, according to authors, associates with frequency growth of idiopathic infertility at men. Revealing and correction of Insulin Resistance not only as early marker of a diabetes 2 types but also as an important component of metabolic neuropathy and sperm oxidative stress’ Pathogenesis can become a perspective method of pathogenetic therapy of male infertility.