GENETIC-DISORDERS IN NORMALLY ANDROGENIZED INFERTILE MEN AND THE USE OF INTRACYTOPLASMIC SPERM INJECTION AS A WAY OF TREATMENT

Objective: To determine the incidence of chromosomal abnormalities in normally androgenized infertile men with no other recognized causes of infertility or who had ever been submitted to other unsuccessful meth ods of treatment. Design: Collaborative retrospective study of clinica l experience collected by an endocrinologist and a geneticist over a 5 -year period. Setting: Outpatients at an endocrinology clinic. Patient (s): Infertile male patients with azoospermia (n = 23), oligozoospermi a (n = 66), and normozoospermia (n = 14) presenting normal (n = 85) or subnormal (n = 18) testicular volume. Intervention(s): All patients w ere submitted to cytogenetic analysis. Main Outcome Measure(s): Two pa tients were referred to intracytoplasmic sperm injection (ICSI), and i n one case, a successful gemellar pregnancy ended up uneventful. Child ren's genetic testings were not performed according to parents' reques t. Result(s): Abnormal karyotypes were found in 11 (10.6%) patients. C hromosomal abnormalities were found in 17.3% of the 23 azoospermic pat ients, in 10.6% of the 66 oligozoospermic patients, and in none of the 14 normozoospermic patients. These disorders were found only in patie nts with normal testicular volumes and no more than 10 x 10(6) spermat ozoa per mL. Conclusion(s): A high incidence of chromosomal abnormalit ies was found in a selected group of normally androgenized infertile m ale patients. The elevated rate of fertilization achieved in one patie nt indicates that ICSI is, at the moment, the only choice for treatmen t of male infertility because of chromosomal abnormalities. (C) 1997 b y American Society for Reproductive Medicine.