The potential effect of clinician-induced (iatrogenic) damage incurred during fertility treatment upon gamete competence and embryonic viability

Infertility affects an estimated 9% of couples worldwide. While advances in assisted reproductive technology (ART) have revolutionised the treatment of infertility, success rates are highly variable. Pregnancy and delivery rates for common techniques such as in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) rarely exceed 30% and 23% respectively. An increasing body of evidence strongly suggests that routine ART techniques may inadvertently induce detrimental effects upon gametes and embryos, compromising either gamete fertility or embryonic viability. Consequently, it is critical that ART protocols are constantly refined or replaced in line with scientific advances, such that clinics can provide patients with an optimised chance of successful conception. Here, we discuss a number of ways in which ART protocols are known to induce detrimental effect upon critical biomarkers of gamete and embryo health, and identify future areas for investigative research. As the number of couples seeking fertility treatment worldwide increases, the efficacy of ART is more important than ever. By informing the research community of the potential ways in which ART may compromise gamete and embryo viability, it is the intention of this commentary to inspire concerted research effort such that ART protocols can be refined or replaced as necessary. © 2013 by Nova Science Publishers, Inc. All rights reserved.