THE GENETICS OF MALE-INFERTILITY

Purpose: We provide an up-to-date summary of the genetic aspects of ma le infertility. Materials and Methods: The literature on male infertil ity was extensively reviewed. Results: Genetic defects are associated with a variety of clinical presentations by the infertile man ranging from gonadotropin-releasing hormone deficiency to spermatogenic failur e to obstructive azoospermia. Microsurgery and micromanipulation of ga metes make it possible for many of these men to father children. Howev er, with each successive breakthrough in treatment of male infertility there is an increased risk of transmitting genetic abnormalities to t he progeny. Conclusions: Transmission of genetic defects through assis ted reproductive techniques can have serious long-term implications. A ssisted reproductive techniques should not be initiated in men with a possible or known genetic cause of infertility without prior genetic c ounseling and risk assessment. Clinicians and researchers involved in reproductive medicine must recognize that, although these techniques h ave revolutionalized the treatment of male infertility, they have the risk of passing genetic abnormalities to the progeny. Therefore, resea rchers must proceed cautiously with development and application of ass isted reproductive technologies to avoid creating future generations o f genetically abnormal individuals. The first step in accomplishing th is goal is through an increased understanding of the genetic basis of male reproductive failure.