INTRACYTOPLASMIC SPERM INJECTION IN INFERTILE PATIENTS WITH STRUCTURAL CHROMOSOME-ABNORMALITIES

In the present study we investigated the results of cytogenetic analys is in male and female patients included in an intracytoplasmic sperm i njection (ICSI) programme for severe male infertility as well as in co nceptuses resulting from these ICSI treatments. In the 261 couples tre ated, 11 male (4.2%) and three female (1.2%) abnormal karyotypes were found, all consisting of structural chromosome anomalies. Chromosomal translocation exhibited the highest frequency (eight males and two fem ales), and there were also three cases of chromosomal inversion (two m ales and one female) and one male with one additional marker chromosom e. There was no difference in fertilization rates among couples with a bnormal (n = 14) and normal (n = 147) cytogenetic results, and the rat es of clinical pregnancy per ICSI attempt were 25.0% (5/20) and 20.6% (78/378) respectively. In pregnancies obtained in couples with normal karyotypes, all of the 108 fetuses were free of chromosomal abnormalit ies. Among the eight fetuses from couples with chromosome structural a nomalies, three out of five and two out of three inherited the cytogen etic defects found in their father or mother respectively. In this ser ies of 83 ICSI pregnancies there were no chromosomal abnormalities oth er than those inherited from the parents. These findings suggest that normal pregnancy rates can be obtained by ICSI in cases of chromosomal translocation in couples with severe male infertility. However, until further evaluations of available data can be performed, cytogenetic a nalysis must be conducted prior to ICSI in men with low sperm counts, and genetic counselling must include prenatal diagnosis for all growin g conceptuses.