Program in the Genetics of Infertility (Progeni)

The mission of the Program in the Genetics of Infertility is to better understand the genetic causes of infertility and to educate patients and clinicians on the nature of such genetic conditions and the potential transmission to offspring.

As with many medical advances, there are benefits and risks associated with the currently available high technology solutions to infertility, such as In Vitro Fertilization (IVF) with Intracytoplasmic Sperm Injection (ICSI). Such technology has allowed men who would otherwise have no chance for paternity the opportunity for biological fatherhood. At present, approximately 60% of IVF cases are performed with ICSI, and the majority of those are performed for male factor infertility. This highly technical approach currently has two genetic risks associated with it:

1 ) the increased chance of children conceived using ICSI to have an extra or missing sex chromosome as compared to children conceived without ICSI (6/1000 compared to 2/1000, respectively)

2) the risk of passing on to offspring the genetic factors that contributed to the male factor infertility, such as chromosome abnormalities, Y chromosome microdeletions, or cystic fibrosis. The program seeks to provide expert, timely and innovative care to patients with infertility who are undergoing testing and considering assisted reproductive technologies.

How may the program help you?

Since science and not nature selects the sperm to be used for ICSI, the processes of natural selection are bypassed. All of the possible ways this could impact children conceived with ICSI are not clear. Because of this, the safest assumption is that genetic risk factors may be passed on to children conceived with this technology that would otherwise not have been possible due to the father's infertility.

Furthermore, it is also conceivable that male offspring of men with infertility may inherit a more severe fertility problem than their father's. In this case, the technology that assisted the father may not help his son to overcome infertility. For these reasons, we offer genetic counseling and testing for at-risk couples who are considering IVF with ICSI.

Who can benefit?

Two groups of couples may benefit from genetic counseling and diagnostic testing services. They are:

1) Couples with infertility due to low or no sperm count.

2) Couples considering IVF with ICSI as an option for assisted reproduction.

What can you expect to happen?

Initially, the patient (optimally, the couple) will have a meeting with the genetic counselor to obtain information about family history and discuss the implications of genetic testing. After testing is completed, patients may be offered another counseling session to review the results and their meaning. The majority of couples who have male factor infertility will be offered chromosome analysis, Y chromosome microdeletion analysis, and/or cystic fibrosis testing. Couples with a family or personal history of a specific genetic condition may also be offered testing appropriate for that condition if it is available.

The intent of genetic counseling program is to help prospective parents become aware of genetic issues that may affect them, even as our knowledge about such issues is evolving.

How can you use this information?

A couple's decision to pursue a high technology pregnancy is a very personal and complex one. It is our belief that this decision, with all of its emotional and financial impact, should be as informed as possible. Information about what genetic conditions may be passed on to future generations is an important component in the decision making process.

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Faculty

Ira Sharlip, MD
James Smith, MD, MS

Key Staff

Gina Davis, MS, CGC
Genetic Counselor
davisg@obgyn.ucsf.edu
415/353-7397

Dennis Troyer, RN, CCRN
Nurse Coordinator
Dennis.Troyer@ucsfmedctr.org
415/353-3075

Liza Jalalian CMT, Laboratory Technician

Appointments & Location

Center for Reproductive Health
UCSF Women's Health Center
2356 Sutter Street, 3rd Floor

Contact Number

Patient Consultation: 415/353-3076
Fax: 415/885-3663

Patient Handouts

Visit our Patient Guides to Urological Treatments section to download Patient Handouts.

Related Links

Center for Reproductive Health
http://www.ucsfivf.org/