Human Reproduction, Vol 12, 1125-1127, Copyright © 1997 by Oxford University Press
D Meschede and J Horst
The prevalence of sex chromosomal anomalies (SCA) is higher after treatment
with intracytoplasmic sperm injection (ICSI) than in naturally conceived
pregnancies. This finding is not only important in the debate about the
genetic safety of ICSI, it also has repercussions on the design of
appropriate strategies for prenatal and preimplantation diagnosis in ICSI
pregnancies. We discuss here in detail the developmental prognosis of
individuals carrying a sex chromosomal anomaly. Major malformations do
occur in Turner syndrome, but not so in Klinefelter, the triple X and the
XYY syndromes. Infertility represents an almost obligate finding in
Klinefelter syndrome, but the latest developments in microassisted
reproduction may help to overcome this problem. Importantly, mental
retardation does not occur more often in individuals with an SCA than in
normal controls. Academic achievement, however, may be somewhat reduced
compared with peers. Overall, for most children carrying a sex chromosomal
anomaly, a major congenital handicap is not to be expected, and the
long-term developmental prognosis is fairly good. Therefore, if an SCA is
diagnosed prenatally in an ICSI pregnancy, an unbiased and detailed
discussion of the developmental perspectives is warranted. The option of
continuing such a pregnancy should be given due consideration.
REVIEWS
Sex chromosomal anomalies in pregnancies conceived through intracytoplasmic sperm injection: a case for genetic counselling
Institute of Human Genetics, Munster, Germany.
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