Genetic basis of male fertility

We are in the age of genetic discovery. Now the human genome has been compl etely sequenced1, there will be increasing understanding and ability to man ipulate biochemical pathways downstream of genes. At the same time, further development of in vitro fertilization (IVF) and intracytoplasmic sperm inj ection (ICSI) will enable procreation in situations that were formerly impo ssible and when there may be an increased possibility of genetic abnormalit y. Furthermore, preimplantation diagnosis will enable defects to be diagnos ed and will give the opportunity for the couple to decide whether to contin ue with treatment towards a pregnancy or not. Thus, there is a need for cli nicians to have a good knowledge of the genetic and hereditary aspects of m ale (and indeed female) infertility and for couples to have access to corre ct information and expert counselling. Also, there are ethical implications of these scientific and clinical advances for the future child, the indivi dual, the couple and society. There is increasing public unease about this new science of reproduction and, in the UK, there is regulation by law; thu s, there is a need for clinicians and scientists to give accurate informati on in everyday language to the public.