Inherited Challenges: Are We Creating Our Future Patients?

January 22, 2016 By Dr. Collin Smikle - Leave a Comment

Often, we focus on evaluating women when couples fail to conceive. Although we know that male factor accounts for 20 – 30% of couples seeking treatment, the treatment remains focused on ovarian stimulation to improve chances for success. With in vitro fertilization, we focus on oocyte retrieval and fertilize these eggs with sperm ejaculated, extracted from the testicle or from the epididymis. Therefore, the eggs can be fertilized directly with intracytoplasmic injection (ICSI) of individual sperm. The sperm source is important but separate in the consideration. If the partner has little or no sperm, we can try to extract immature of immotile sperm from the testes and still provide the opportunity for parenting. If fertilization fails, we may point to the sperm quality or function but still question the quality of the egg as the main cause for these challenges. Still, there are some men who the cause began earlier and there aren’t any sperm cells (germ cells) within the testes.

This article points to a more specific cause for challenges in men with azoospermia (no sperm with ejaculation) and reinforces that, even if successful, we aren’t dealing with the complete issue. The Tex11 gene identified first in mice and then a group of men and their families confirms that we need to investigate the causes of azoospermia more clearly. Moreover, the cause relates to a specific gene on the X chromosome and is transferred maternally. These men may have brothers or uncles who remain childless for the same reason. Women who have this disorder will transmit this to their daughters so they will pass this on as well. The children born to couples with this disorder may face similar challenges conceiving in the future and all the females within this line will transmit the gene to their children.

Therefore, should we be testing women for the causes as well so that their sons aren’t affected? Only time will tell.

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