Outcomes for offspring of men having ICSI for male factor infertility

Abstract

Since the introduction of intracytoplasmic sperm injection (ICSI) using single sperm isolated from testicular tissue in men with obstructive and non-obstructive azoospermia, or using ejaculated sperm in those with poor semen quality, there have been concerns that this might have adverse effects on the offspring compared to conventional in vitro fertilisation (IVF) and natural conceptions. ICSI is done for reasons other than male factor infertility, and on the whole has not been shown to have any more negative effects than those seen with IVF. There have however, been very few studies of ICSI with a focus on, or large enough numbers to examine, the specific outcomes associated with male factor infertility. From the limited information available in relation to the source of the sperm and aetiology of infertility in the presence of ICSI, there appears to be no increased risk of congenital malformations. There is, however, a small increase in both de novo and inherited chromosome abnormalities. In terms of growth and neurodevelopment, there are very few studies, and so far, no adverse outcomes have been found in young children whose fathers have a sperm defect. The origin of the sperm used in ICSI does not have a major influence on the early life outcomes for the offspring, but transgenerational and epigenetic effects remain unknown. When the male factor infertility is known or thought to be due to a Y-chromosome deletion, this information should be given to the young male offspring at a time that will ensure his own reproductive health and plans are optimized.

Y chromosome AZFc microdeletion may not affect the outcomes of ICSI for infertile males with fresh ejaculated sperm

“…The treatment outcomes of infertile men who suffered from Y chromosome microdeletion has been controversial. Some studies have demonstrated comparable treatment outcomes in patients with or without Y chromosome microdeletions [22,23]. However, other studies showed different outcomes, particularly in fertilization rate and quality of embryos between these two groups.…”

“…Indeed, can we consider male infertility as a severe handicap, justifying sex selection [33]? Extensive counseling should be provided to all couples before and after genetic testing [23], especially for the couples that decide to pursue PGD. The PGD procedure has a high economic burden on patients and more importantly, the risks to offspring health are still debatable.…”

The CFTR polymorphisms poly-T, TG-repeats and M470V in Chinese males with congenital bilateral absence of the vas deferens

“…33 Clinically, intracytoplasmic single sperm injection can be used to provide fertility for men with cystic fibrosis or CBAVD. 34 However, the CFTR mutation can be transmitted to the next generation by intracytoplasmic single sperm injection, even in a population with a low prevalence of CF, 35 so the risk of having children with CF or CBAVD will be increased. 33 At present, a careful clinical examination of children seems to be mandatory when the father has CBAVD.…”

Intracytoplasmic Sperm Injection – Factors Affecting Fertilization

“…There is, however, a small increase in both de novo and inherited chromosome abnormalities. In terms of growth and neurodevelopment, there are very few studies, and so far, no adverse outcomes have been found in young children whose fathers have a sperm defect [113].…”