ICSI and Male Infertility: Consequences to Offspring

Over 8 million children have been born after assisted reproductive technology (ART) worldwide. Intracytoplasmic sperm injection (ICSI), which involves the microinjection of a single spermatozoon into an oocyte cytoplasm, has not only become the method of choice to overcome severe male factor infertility but also the most common method of fertilization in ART. ICSI utilization raises concerns about the health and well-being of the children born after the procedures. These concerns relate to the fact that ICSI bypasses natural selection mechanisms that would otherwise eliminate unfit products. In this chapter, we summarize the risks for congenital malformations, epigenetic disorders, chromosomal abnormalities, infertility, cancer, delayed psychological and neurodevelopment, as well as impaired cardiometabolic profiles in ART offspring and discuss if the increased health risks are associated with the couple’s reproductive history and infertility factors or to the ART treatments by itself.