Clinical application of new micromanipulative technologies to treat the male

Traditional treatments of the male have produced no improvement in sperm parameters. Since the rate of normal fertilization rate is significantly lower in these cases after classic in-vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) has become the preferred method of treatment. It has been successfully applied in cases of extreme oligoasthenoteratozoospermia, and obstructive and non-obstructive azoospermia. Cryopreservation of testicular tissue will replace the repeated use of fresh testicular tissue. Full information has to be provided to patients about the frequency (approximately 3%) of sex chromosome and autosomal aberrations in men with extreme oligoasthenoteratospermia. The need for screening for Yq deletions is still under study, and any therapeutic consequences for the newborn child will have to be analysed. The incidence of major malformations in newborn children is approximately 2.5%, i.e. comparable with that of the general population. Screening for de-novo sex chromosome aberrations may be particularly useful for men with sperm counts of < 5 x 10(6) and those with non-obstructive azoospermia.