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Human Reproduction, Vol. 14, No. 8, 2166-2169, August 1999
© 1999 European Society of Human Reproduction and Embryology

Reproductive decisions of men with microdeletions of the Y chromosome: the role of genetic counselling

Annemiek W. Nap1, Ron J.T. Van Golde1, Joep H.A.M. Tuerlings2, Paul De Sutter3, Math H.E.C. Pieters4, Jacques C. Giltay5, Peter M.M. Kastrop6, Didi D.M. Braat1 and Jan A.M. Kremer1,7

1 Department of Gynaecology and Obstetrics, 2 Department of Human Genetics, University Hospital Nijmegen, The Netherlands, 3 Department of Obstetrics and Gynaecology, University Hospital Gent, Belgium, 4 Laboratory of In vitro Fertilisation, University Hospital Dijkzigt, Rotterdam, 5 Clinical Genetics Centre, Utrecht and 6 Department of Obstetrics and Gynaecology, University Hospital Utrecht, The Netherlands

Couples dealing with microdeletions of the Y chromosome have to make decisions about their reproductive future. Do they opt for intracytoplasmic sperm injection (ICSI), artificial insemination with donor insemination (AID) or no treatment? We analysed this decision in 28 couples and investigated the role of the counsellor and the counselling process on the final decision of the couple. Ten counsellors from six fertility clinics in The Netherlands and Belgium were interviewed about their genetic counselling of couples dealing with microdeletions. The answers to the questionnaire were converted to 11 dichotomous variables. Of the 1627 tested men in the six centres, 37 (2.3%) had a microdeletion in the AZFc region, a subregion of the AZF region on the Y chromosome important for normal spermatogenesis. The decisions of 28 of them could be analysed. Most couples chose ICSI (79%). The remaining couples chose donor insemination (7%) or refrained from treatment (14%). Several variables, including the counselling procedure, the counsellor and the available treatments in the fertility centre, influenced the decision of the couple. In conclusion, most couples dealing with microdeletions in the AZF region choose ICSI. Several aspects of the process of genetic counselling appear to be related to the final decision.

Key words: assisted reproduction/genetic counselling/ICSI/male infertility/microdeletions

7 To whom correspondence should be addressed at: Department of Gynaecology and Obstetrics, University Hospital Nijmegen,PO Box 9101, 6500 HB Nijmegen, The Netherlands


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