The techniques of assisted reproduction have recently become the most effective methods of treatment of infertility;
namely ICSI (intra-cytoplasmic sperm injection), MESA (microepididymal sperm aspiration), TESA (testicular
sperm aspiration) and TESE (testicular sperm extraction). The techniques have been increasingly successful, even
above the average efficiency of classical IVF (in vitro fertilization). It can be demonstrated by the percentage of
ICSI - aided births percentage per 100 % of embryotransfers in ISCARE; 1996 = 21.3 %, 1997 = 26.15 %, 1998 =
29.7 %. The successful use of these techniques is associated with the rise of risks which result from the selection of
couples for assisted reproduction with genetic-based infertility and with the rise of risks involving the introduction
of genetic-based defects into the next generation. Presently, a list of indications is being developed, which, while
still not accepted officially, identifies patients for genetic counselling. Only the counselling center has the competence
to estimate genetic risks over generations. Subsequently, after selection by the center, during 1997 and 1998 the
chromosomes of 731 patients were cytogenetically examined, representing 429 infertile couples from the centres
ISCARE, PRONATAL, FERTIMED, and CAR 1. LF UK. Within these 429 couples, belonging to four groups of
indications, the cytogenetic examination was informative in 8.15 %. This finding of a relatively high percentage (10
times more than in the general population) confirms the validity of the list of indications and the necessity of
cooperation among the genetic counselling center, cytogenetic laboratory and the IVF centre.
assisted reproduction, genetic based infertility, qenetic based risk, cytogenetic examination.