GENETIC RISK IN MICROMANIPULATIVE ASSISTED REPRODUCTION

The empirical data on pregnancy outcome after intracytoplasmic sperm i njection (ICSI) are encouraging, but still insufficient to rule out de finitely adverse genetic or teratological effects, We analyse potentia l adverse effects of ICSI by applying general principles of genetic an d teratological risk assessment. The role of gamete micromanipulation as a possible teratogen is discussed. We consider whether ICSI patient s are at increased risk for carrying and propagating genetic lesions o f different kinds, The possible interference of ICSI with genomic impr inting and pre-zygotic sperm selection is reviewed and we discuss the potentially protective role of DNA repair in oocytes. Considering the available empirical data and the conclusions from our theoretical anal ysis it appears that neither lassitude nor over-concern about adverse effects of ICSI are justified.