Are there genetic risks associated with microassisted reproduction?

Of all the techniques available for microassisted reproduction, the direct injection of individual sperm cells or spermatids into the cytoplasm of the oocyte (ICSI) is the most invasive, through which any possible selection against sperm cells with genomic defects would be excluded. It has, however, been shown that such a possible selection is present neither in the female genital tract nor at the zona pellucida. Selection against genetic-based defects occurs after the fertilization of the oocyte, during both embryonic and fetal development. Based on the data to date, it can be assumed that ICSI would not result in either a significant increase in genetic-based diseases, or in an increase in the number of infertile males. If, however, mutations of X-chromosomal or Y-chromosomal genes should play a major role in male fertility disorders, one could expect, over generations, an increase, though probably very slight, in the number of males with such disorders.