Public Health Genetics, Murdoch Children's Research Institute, Parkville, Vic., Australia.
Asian J Androl. 2012 Jan;14(1):116-20. doi: 10.1038/aja.2011.71. Epub 2011 Dec 12.
Since the introduction of intracytoplasmic sperm injection (ICSI) using single sperm isolated from testicular tissue in men with obstructive and non-obstructive azoospermia, or using ejaculated sperm in those with poor semen quality, there have been concerns that this might have adverse effects on the offspring compared to conventional in vitro fertilisation (IVF) and natural conceptions. ICSI is done for reasons other than male factor infertility, and on the whole has not been shown to have any more negative effects than those seen with IVF. There have however, been very few studies of ICSI with a focus on, or large enough numbers to examine, the specific outcomes associated with male factor infertility. From the limited information available in relation to the source of the sperm and aetiology of infertility in the presence of ICSI, there appears to be no increased risk of congenital malformations. There is, however, a small increase in both de novo and inherited chromosome abnormalities. In terms of growth and neurodevelopment, there are very few studies, and so far, no adverse outcomes have been found in young children whose fathers have a sperm defect. The origin of the sperm used in ICSI does not have a major influence on the early life outcomes for the offspring, but transgenerational and epigenetic effects remain unknown. When the male factor infertility is known or thought to be due to a Y-chromosome deletion, this information should be given to the young male offspring at a time that will ensure his own reproductive health and plans are optimized.
自从在梗阻性和非梗阻性无精子症男性中使用从睾丸组织中分离的单个精子或在精液质量差的男性中使用射出的精子进行胞质内精子注射（ICSI）以来，人们一直担心与传统的体外受精（IVF）和自然受孕相比，这可能对后代产生不利影响。ICSI 是出于非男性因素不孕的原因而进行的，总体而言，并没有显示出比 IVF 更多的负面影响。然而，很少有研究专门针对 ICSI 进行，也没有足够大的样本量来检查与男性因素不孕相关的特定结果。根据与 ICSI 时精子来源和不孕病因相关的有限信息，似乎没有先天性畸形风险增加。然而，新出现的和遗传性染色体异常确实略有增加。就生长和神经发育而言，研究非常少，到目前为止，尚未发现父亲精子有缺陷的幼儿出现不良后果。ICSI 中使用的精子的来源对后代的早期生活结果没有重大影响，但跨代和表观遗传效应仍不清楚。当男性因素不孕已知或被认为是由于 Y 染色体缺失时，应在确保年轻男性自身生殖健康和计划得到优化的时间向其提供此信息。
