Chapter 16, Problem 1CS

Would ISCI be an option? Why or why not?

Jan, a 32-year-old woman, and her husband, Darryl, have been married for 7 years. They have attempted to have a baby on several occasions. Five years ago, they had a first-trimester miscarriage, followed by an ectopic pregnancy later the same year. Jan continued to see her OB/GYN physician for infertility problems but was very dissatisfied with the response. After four miscarriages, she went to see a fertility specialist, who diagnosed her with severe endometriosis and polycystic ovarian disease (detected by hormone studies). The infertility physician explained that these two conditions were hampering her ability to become pregnant and thus making her infertile. She referred Jan to a genetic counselor.

At the appointment, the counselor explained to Jan that one form of endometriosis (MIM 131200) can be a genetic disorder, and that polycystic ovarian disease can also be a genetic disorder (MIM 184700) and is one of the most common reproductive disorders among women. The counselor recommended that a detailed family history of both Jan and Darryl would help establish whether Jan’s problems have a genetic component and whether any of her potential daughters would be at risk for one or both of these disorders. In the meantime, Jan is taking hormones, and she and Darryl are considering alternative modes of reproduction.

Using the information in Figure 16.4, explain the reproductive options that are open to Jan and Darryl.

Summary Introduction

To determine: Whether intra cytoplasmic sperm injection (ISCI) is an option for given the couples.

Introduction: Ms. J (32 years old woman) and Mr. D have been married for 7 years. Their attempts to have a baby have failed every time as Ms. J has experienced 4 miscarriages. The fertility specialist diagnosed Ms. J with severe endometriosis and polycystic ovarian disease and explained that these two conditions were making Ms. J infertile. The genetic counselor explained that both these conditions were genetic. Therefore, detailed family history needs to be observed to determine the potential risk of any of her daughter to have the disease.

Explanation of Solution

Intra cytoplasmic sperm injection (ISCI) is used to treat the male infertility problems of low sperm count or motility. In this procedure, an egg is injected with a carefully selected single sperm from the male partner. The embryo develops in an incubator and it is then transferred to the uterus of the female partner.

With reference to given case study, ISCI would not be an option for Ms. J and Mr. D because Mr. D does not have the infertility problem. Ms. J is infertile because of her endometriosis and polycystic ovarian disease. Because of these two conditions, Ms. J cannot carry a child to the full term. They may choose surrogacy as an option.

Hence, it can be concluded that ISCI cannot be an option in this case because there is no infertility problem related to male.