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Male factors are the commonest single cause of infertility (1).
- the technique of intracytoplasmic sperm injection (ICSI) has revolutionised
the treatment of patients with moderate to severe oligoasthenoteratozoospermia
and other sperm dysfunctions; it has also enabled treatment of patients with
azoospermia (either resulting from non-obstructive or obstructive origin)
via the surgical retrieval of testicular or epididymal spermatozoa
- it has been suggested that ICSI results in a slight, but significant, increased
incidence of sex chromosomal abnormalities in children born as a result of
ICSI (2). However a case-control study by AG Sutcliffe et al (3), of neurodevelopmental
delay among children in their 2nd year of life who have been conceived via
ICSI, showed no difference between the 2 groups. Also congenital abnormality
rates were similar between the 2 groups - however there was a trend to a slightly
higher incidence of congenital abnormalities (particularly of the genital
tract) in children born to fathers with azoospermia
- ICSI has been used as a treatment option in non-male-factor infertility
NICE suggest that (4):
- (1) Irvine DS (1998). Epidemiology and etiology of male infertility. Hum
Reprod, 13 (suppl 1), 31-44.
- (2) Bonduelle M et al (1999). Seven years of ICSI and follow-up of 1987
subsequent children. Huma Reprod, 14 (suppl), 243-64.
- (3) Sutcliffe AG et al (2001). Outcome in the second year of life after
in-vitro fertilisation by intracytoplasmic sperm injection. Lancet, 357 (9274),
- (4) NICE (February
2013).Fertility - Assessment and treatment for people with fertility problems
Last reviewed 01/2018