[Predictable male causes of in vitro fertilization (IVF) with intra cytoplasmic sperm injection (ICSI) failure]

The decision not to initiate or to stop a therapeutic treatment for infertility is, for the clinician, probably one of the most difficult to make. This can only be done on strong biological arguments, indicating the poor likelihood of success for the couple. The patients can then be oriented toward a more realistic alternative without going through the heavy IVF/ICSI procedure. Until recently, Y microdeletions were the only genetic anomalies leading to idiopathic cases of male infertility. New genes have recently been identified that can be of diagnostic value. We will not propose here an exhaustive list of all "desperate cases" but will give some examples of rare phenotypes where IVF treatment does not seem appropriate. How to make that announcement to the patients is a debate that still remains open.