ICSI: Creating a Generation of Infertile Children?

A study* conducted at the Institute of Child Health in London comparing 211 six-year-olds conceived through Intracytoplasmic sperm injection (ICSI) with 195 six-year-olds conceived naturally, found that boys in the ICSI group had significantly shorter fingers. The study concluded that perturbations in finger length in ICSI children may be inherited from their fathers and, in the case of boys, could be associated with lower fertility and reduced sexual attractiveness.

CORE comments:
We note that ICSI is becoming the preferred option in infertility treatment. This is despite the invasive nature of the technique and the risk of long-term health problems to resulting offspring. A pioneer of the technology behind ICSI, Andre Van Steirteghem, recently criticised the trend amongst IVF clinics to overuse the treatment in unnecessary cases. Van Steirteghem conceded that this and other artificial reproductive technologies were creating a generation of children who would be more prone to infertility.

Many procedures used in IVF, besides ICSI, have yet to be properly validated. In the interests of the welfare of children and the adults themselves we should insist that safety issues are robustly addressed.

*Perturbations in finger length and digit ratio (2D:4D) in ICSI children
Reproductive BioMedicine Online, Volume 20, Issue 1, Pages 138-143
A. Sutcliffe, J. Manning, A. Katalanic, A. Ludwig, M. Mehta, J. Lim, E. Basatemur, M. Ludwig
http://www.rbmojournal.com/article/S1472-6483(09)00204-1/abstract

Embryo Ruling Keeps Stem Cell Research Legal*

On 15th December 2009, the Irish Supreme Court ruled in the case of Roche v Roche & Others that human embryos outside of the womb were not ‘unborn’ and therefore could not receive protection under the country’s Constitution. Abortion is illegal in Ireland which “acknowledges the right to life of the unborn” enshrined in its Constitution. However the legality of assisted reproduction and research with human embryonic stem cells (hESCs) has been uncertain for a number of years. The case before the court, in which a woman wanted to implant frozen embryos against the wishes of her estranged husband, did not directly involve stem cell research, but an opposite ruling could have made such work unconstitutional. Commentators on both sides of the debate are now calling for Parliament to produce regulation in order to properly address this lacuna in the law.

CORE comments:
The status of the human embryo has not been satisfactorily determined in most countries in the world, but it is particularly sad to see Ireland adopting this position in favour of the father over the right to life of the embryo.

* Embryo Ruling Keeps Stem Cell Research Legal
Science 1 January 2010: Vol. 327. no. 5961, p. 25
G Vogel

http://www.sciencemag.org/cgi/content/short/327/5961/25

Paternal Age Linked to Reduced Fertility

Scientists reviewing the link between male age and genetic abnormalities in the germ line* have found that increased paternal age can be associated with decreasing androgen levels, decreased sexual activity, alterations of testicular morphology and a deterioration of semen quality (volume, motility, morphology). Paternal age also has an influence on the integrity of sperm, increases telomere length in spermatozoa and is suggested to have epigenetic effects. These results may go some way to explaining the association of paternal age over 40 years with reduced fertility, an increase in pregnancy-associated complications and adverse outcome in offspring.

CORE comments:
This study is of particular interest. Reduced fertility in the older female is already widely acknowledged, but associations of age-related fertility problems with the male are less likely to be studied, and rarely in relationship to the health of the offspring.

*Paternal age and reproduction
Human Reproduction Update,
Vol. 16, No. 1 pp. 65-79, 2010
G.A. Sartorius and E Nieschlag
http://humupd.oxfordjournals.org/cgi/content/abstract/dmp027v1

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