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20 April 2000
Fathers Can Pass Along Infertility
by George Atkinson

Talk about creating work for yourself. Evidence suggests that a common method of artificial insemination is passing on a genetic defect that causes infertility in one out of every 2,000 men. This would seem to be excellent news for artificial inseminators.

Intracytoplasmic sperm injection or ICSI, "is now a standard part of the repertoire of assisted reproduction," said Dr. David Page of Whitehead Institute for Biomedical Research. "There have been thousands of children born through ICSI. There will be thousands more this year and for years to come."

ICSI, which costs between $5,000 and $12,000 for each attempt, involves injecting single sperm into individual eggs and transferring the resulting embryos into a woman's reproductive system.

The procedure is ideal for men with Y chromosome deletions because it requires only a few sperm, which can usually be retrieved from the patient's semen or testes.

But Page's research confirms what scientists suspected: ICSI allows male infertility caused by the deletions to be passed from father to son. It has long been understood that male infertility is not, indeed cannot, be passed on via traditional methods of reproduction.

Many cases of male infertility are genetic in origin. Deletions on the Y chromosome are the most common cause of little or no sperm production.

The finding raises a host of ethical questions, including: Should men with low sperm counts be tested prior to ICSI to determine whether they could have a son who will also be infertile?

"I understand in April, Germany started requiring DNA testing of the Y chromosome before allowing ICSI," Page said.

He said in Europe government regulations on assisted reproduction "varies from country to country."

Artificial reproduction is essentially unregulated in the United States with decisions usually left to patients and their doctors.




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