Compared with other mammals, humans as a
species are relatively infertile. Various studies
suggest that in young, unselected couples, who
are trying to conceive, 20–25% of them should
be successful each monthly cycle (Bonde et al.
1998; Edwards & Brody, 1995). This compares
with an average of 70% in captive baboons for
example (Stevens, 1997). Interestingly, the implantation rate after in vitro fertilisation (IVF)
at best averages around 20% per embryo
transferred (Edwards & Beard, 1999). Evidence
is steadily accumulating to prove that the major
cause of implantation failure in humans after
both in vivo and in vitro fertilisation is the high
incidence of chromosomal abnormality. Combining data from cytogenetic studies of
spontaneous abortions with those obtained from
preimplantation embryos suggests that meiotically derived aneuploidy occurs in 25% of
conceptions, an order of magnitude higher than
is found in other well studied species such as the
mouse (Hassold & Jacobs, 1984; Jamieson,
1994). Additionally, interphase fluorescent in
situ hybridisation (FISH) analysis of three day
old human embryos has shown that up to 50%
are chromosomally mosaic (Delhanty et al. 1997;
Munné et al. 1998), further increasing the chance
of implantation failure. This review covers the
evidence accumulating from a variety of sources
that poor fertility in humans has a chromosomal
basis.