There’s been a great deal of discussion here about the importance of/significance of a genetic link between parent and child. (You can go back to the post before last to get a taste of the discussion, or you can try out some of the tags.) While pondering those issues I noticed a recent panel on assisted reproductive technology (ART) at the American Association for the advancement of Science (AAAS) annual meeting.
There was a discussion of the concerns arising from increasing use of a intracytoplasmic sperm injection–otherwise known as ICSI. (That’s pronounced “ick-see,” if you are wondering.) In ICSI an embryologist injects a single sperm into an egg in the hopes of spurring conception.
There’s a striking chart on the pages of the Human Fertilisation and Embryology Authority (the UK regulating agency) that shows the increasing use of ICSI. (I’m not at all clear about how one can do ICSI alone–as I understand it, ICSI must be coupled with IVF, because the sperm is injected into the egg outside the woman’s body and then the fertilized egg is transferred into her uterus. But I’m just going to skip this confusion.) It’s harder to find statistics for the US (and if anyone wants to point me to some, so much the better) but I’m confident they’d show the same trend.
Now the discussion at the AAAS suggests there is good reason to be concerned about the rising use of ICSI. Abnormal sperm, that would not have been able to fertilze an egg under ordinary circumstances, may be used for conception in ICSI. The resulting offspring may be at increased risk of genetic abnormalities.
The scientists quoted in the article suggest that the use of ICSI has become too routinized–and indeed, the chart I linked to suggests that its use is routine in IVF. (I suppose it is viewed as insurance that fertilization will occur.) And the proposed solution is to restrict its use to instances where it is necessary–where sperm motility is low, for example.
But it seems to me that cases where the man’s sperm is generally unhealthy are those most likely to generate the problematic result. In view of these risks, why is ICSI use flourishing?
The answer, it seems to me, is that it allows a heterosexual couple who might previously have used donor sperm to create a child that is genetically related to both parents. Whatever the risk, it’s worth it to people in order to have a child that is genetically related to her/his father. This strikes me as a terribly problematic calculation.
(Some of the papers from the panel generated some mainstream media coverage, too.)