Answer from: Douglas Lester, PhD, MSc, BSc (Hons)
You usually need two bad infertility genes to be infertile. It’s a rare event, and normally, you only pass on one of these bad genes to your child, who won’t then suffer from your infertility problem. That will happen maybe 90-95% of the time. So for most infertile couples, the child is unaffected.
However, if the sex chromosome genes are affected, rare X or Y gene defect, they will be passed on to male children by genes like TEX11. If they’re mutated on the X chromosome from a female, and she passes on that X chromosome to her son, then the son will be infertile as well. For such couples, they need to go to genetic counseling, and they may recommend that they do a preimplantation diagnosis (PGD) where you take some cells from the embryos (from IVF or ICSI) and see which ones are female and just implant female embryos and that way you’ll end up with unaffected female offspring and that gene won’t be passed on. Or you go ahead and have a son, and you know he will be infertile; that’s a very difficult decision. These people need to see a genetic counselor for the sex chromosome.
Fortunately, most of them are on the autosomes and not the sex chromosomes. If the X and Y genes are affected, then the best solution is to have daughters. We need more women in the world. That would overcome the problem of sex chromosome mutations. There are dominant ones, but you could do a pre-implantation diagnosis to overcome dominant ones, but they are rare.
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