Résumé
La prise en charge de l’infertilité masculine a été transformée depuis une quinzaine d’années par la micro-injection de spermatozoïde dans l’ovocyte (intra cytoplasmic sperm injection ou ICSI). L’ICSI permet d’obtenir des grossesses au sein de couples infertiles dans des situations très diverses, à tel point que le diagnostic étiologique de l’infertilité masculine et son éventuel traitement peuvent passer au second plan au profi t d’une ICSI systématique (1, 2). Cette évolution caricaturale risquerait à terme d’alourdir l’assistance médicale à la procréation (AMP) et de laisser plus de couples dans l’échec. En effet, dans certains cas, l’amélioration des paramètres spermatiques peut permettre d’éviter l’ICSI et d’avoir recours à des techniques plus simples comme les inséminations intrautérines (IIU), voire d’obtenir des grossesses naturelles. Lorsque l’ICSI reste nécessaire, l’optimisation des paramètres spermatiques peut améliorer ses résultats ou la rendre réalisable lorsqu’elle était impossible.
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Thiounn, N. (2011). Diagnostic et prise en charge de l’infertilité masculine. In: Physiologie, pathologie et thérapie de la reproduction chez l’humain. Springer, Paris. https://doi.org/10.1007/978-2-8178-0061-5_33
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DOI: https://doi.org/10.1007/978-2-8178-0061-5_33
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