الفهرس 
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Abstract
Infertility is defined as the inability to conceive after 12 months or more of regular unprotected sexual intercourse. It is a major health problem with multi-factorial etiology that affects approximately 14-22% of couples worldwide. In Egypt, the total infertility prevalence rate is 12% with infertility due to male factor constituting about 13-46% of infertile couples presenting to ART clinics, where in 13% male factor was the sole cause of infertility and in 46% of cases male factor was involved.
The advent of ICSI has updated the treatment of male infertility, it greatly reduces the requirements for sperm/semen quality and quantity and hence improving the probabilities of achieving pregnancy. However, many concerns have been raised about its safety; the genetic consequences of utilizing sperms from infertile men. Prenatal diagnosis of ICSI pregnancies indicates an increased incidence of chromosomal aneuploidies. Normal somatic karyotype does not exclude germ cell aneuploidy; normal karyotype infertile male patients may produce aneuploid gametes.
Fluorescence in situ hybridization facilitated the study of numerical chromosomal abnormalities in human sperm nuclei (sperm FISH). Sperm aneuploidy has a negative impact on ICSI outcome. It is directly related to reproductive failure either by fertilization failure, implantation failure or early abortion after ICSI. Sperm-FISH can be used to direct reproductive counselling, clinical management, and to allow the couple to make an informed reproductive decision; either to perform PGD testing or to choose adoption. It may help to reduce the high financial and emotional expense of repeated ICSI failure.
The aim of the present study was to determine the frequency of sperm aneuploidies for chromosomes 13, 18, 21, X and Y in semen ejaculates from infertile men with failed ICSI. The study was performed on 35 normal karyotype infertile men with history of failed ICSI, in addition to 10 normal fertile men with normal semen as controls. All patients were subjected to full history taking and laboratory investigations including complete hormonal profile in addition to computerized semen analysis. FISH technique was performed for semen samples after specific processing and spreading, followed by decondensation treatment and washes before applying the probe, examination of slides and scoring of sperm nuclei, finally statistical analysis to obtain result.
Sperm FISH examination revealed that normal karyotype infertile patients with different semen abnormalities had statistically significant higher frequency of sperm chromosomal aberrations (disomy, nullisomy and diploidy) for all examined chromosomes compared to normal fertile controls, with the exception of disomy XY, that was higher in the patients group, but the difference between the two groups was not statistically significant. In addition, a statistically significant correlation was detected between sperm concentration, abnormal sperm morphology, semen volume and sperm chromosomal aberrations. Moreover, ICSI failure was found to be directly correlated with abnormal sperm morphology and with sperm aneuploidy (sex chromosome nullisomy, aneuploidy sex chromosome, total aberration X, Y,