Ethics of intracytoplasmic sperm injection: proceed with care

The religious and feminist objections to the new reproductive technologies in general and intracytoplasmic sperm injection (ICSI) in particular are not convincing. The risks and uncertainties associated with ICSI constitute a compelling reason to subject clinical ICSI with ejaculated spermatozoa to strict conditions and are a good reason to suspend clinical microsurgical epididymal sperm aspiration and testicular sperm extraction, pending the results of animal research. The categorical objections to 'coercively' offering genetic testing to males/couples applying for ICSI are not convincing in view of the doctors' own responsibility to avoid serious harm to the future children. At the same time, a further debate on the harm-probability ratio to be used for such testing and for limiting access to ICSI is necessary.