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PubMed This is a summary of 15 peer-reviewed journal articles Updated
Medical Genetics

The Genetic Legacy: Inheritance and Future Sons

At a Glance

If a man with a Y chromosome microdeletion conceives using ICSI, 100% of his biological sons will inherit the condition and associated infertility. Couples can prevent passing on the deletion by using PGT-A during IVF to select and transfer only female embryos.

If you choose to pursue biological fatherhood through ICSI (intracytoplasmic sperm injection), you face a unique genetic crossroad. Because the Y chromosome is passed exclusively from father to son, any boy conceived using your sperm will inherit your Y chromosome—and the microdeletion it carries [1][2].

The Genetic Legacy

For many men, the realization that they will pass on their infertility can be emotionally taxing [3]. It is important to understand the biological reality of this transmission:

  • 100% Transmission Rate: If a biological son is conceived using your sperm, he will inherit the deletion [4][5].
  • Predicting the Future: Generally, a son will have a similar fertility profile to his father [2]. However, in some cases of partial deletions (like the b2/b3 or gr/gr subtypes), the deletion can actually “expand” or become more severe when passed to the next generation, potentially leading to even lower sperm counts for the son than the father experienced [6][7].
  • Female Offspring: Daughters do not inherit a Y chromosome and therefore cannot inherit or carry the microdeletion [1].

Screening Options: Why PGT-A is the Clinical Path

To manage this “genetic legacy,” some couples choose to use Preimplantation Genetic Testing (PGT) on their embryos before they are transferred to the uterus.

It is important to understand a crucial biological limitation: because you only have one Y chromosome, 100% of the Y chromosomes in your sperm carry the deletion. Therefore, there is no way to use genetic testing to “find an unaffected male embryo.” It is scientifically impossible to select a male embryo without the YCMD [8].

Instead, couples who wish to avoid passing on the trait rely on PGT-A (Aneuploidy Screening and Sex Selection) [8][9]. This common method checks the overall number of chromosomes and identifies the sex of the embryo [9]. Couples can use this technology to select only female embryos for transfer, thereby ensuring the Y-microdeletion is not passed on [9][10].

The Emotional and Ethical Weight

The decision to use PGT-A for sex selection is deeply personal and involves several trade-offs:

  • Reduced Embryo Pool: By choosing to only transfer female embryos, you are excluding male embryos that could have resulted in a successful pregnancy [9][10]. This reduces the overall chance of having a baby from a single IVF cycle [11].
  • Clinic Policies and Ethics: While sex selection for purely “social” reasons is controversial or even prohibited in some regions, many medical societies consider sex selection to avoid passing on a genetic disorder (like YCMD) to be a valid, medically indicated use of the technology [12][13]. Check your local laws and clinic policies.
  • Parental Perspective: Some fathers feel a strong desire to spare their sons the medical and emotional “gauntlet” of infertility [14]. Others feel that since they have lived a full and healthy life despite their infertility, their son can as well, especially as medical technology continues to advance [3].

Navigating these choices requires the support of a genetic counselor [14]. They can help you process the clinical risks, discuss clinic capabilities, and handle the emotional weight of your decision [4][15].

Common questions in this guide

Will my son inherit my Y chromosome microdeletion?
Yes. Because the Y chromosome is passed exclusively from father to son, any biological male child conceived using your sperm will inherit the microdeletion and will likely experience similar or more severe infertility.
Can genetic testing find a male embryo without the Y microdeletion?
No. Because you only have one Y chromosome, every single Y chromosome in your sperm carries the deletion. It is biologically impossible to find or select an unaffected male embryo from your sperm.
How can we prevent passing a Y chromosome microdeletion to our children?
Couples can use Preimplantation Genetic Testing (PGT-A) during the IVF process to determine the sex of their embryos. By choosing to transfer only female embryos, which do not inherit a Y chromosome, the deletion is not passed on to the next generation.
Can a partial Y microdeletion get worse when passed to my son?
Yes, it is possible. In some cases involving partial deletions, such as the b2/b3 or gr/gr subtypes, the genetic deletion can expand when passed to the next generation. This may lead to a lower sperm count for the son than the father experienced.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.What is the risk that my partial deletion (if applicable) could expand into a complete deletion in my son?
  2. 2.Does our clinic offer PGT-A for sex selection to prevent the transmission of genetic traits?
  3. 3.What are the specific local laws and ethical guidelines our clinic follows regarding sex selection for medical conditions like YCMD?
  4. 4.Are there any long-term health concerns for sons born with this deletion besides infertility?
  5. 5.How many healthy embryos would we realistically need to produce to make sex selection a viable strategy for us?

Questions For You

Tap a prompt to share your answer — we'll use it plus this page's context to start a tailored conversation.

References

References (15)
  1. 1

    The genetic aetiology of male infertility: clinical and forensic implications.

    Anand R, Dave V, Shukla MA

    Molecular biology reports 2026; (53(1)):364 doi:10.1007/s11033-026-11515-5.

    PMID: 41636934
  2. 2

    Microdeletions and vertical transmission of the Y-chromosome azoospermia factor region.

    Deng CY, Zhang Z, Tang WH, Jiang H

    Asian journal of andrology 2023; (25(1)):5-12 doi:10.4103/aja2021130.

    PMID: 35259786
  3. 3

    Early detection of Y chromosome microdeletions in infertile men is helpful to guide clinical reproductive treatments in southwest of China.

    Liu T, Song YX, Jiang YM

    Medicine 2019; (98(5)):e14350 doi:10.1097/MD.0000000000014350.

    PMID: 30702623
  4. 4

    Genetics of the human Y chromosome and its association with male infertility.

    Colaco S, Modi D

    Reproductive biology and endocrinology : RB&E 2018; (16(1)):14 doi:10.1186/s12958-018-0330-5.

    PMID: 29454353
  5. 5

    Y Chromosome Microdeletions in Infertile Men with Non-obstructive Azoospermia and Severe Oligozoospermia.

    Kim SY, Kim HJ, Lee BY, et al.

    Journal of reproduction & infertility 2017; (18(3)):307-315.

    PMID: 29062795
  6. 6

    Natural Transmission of b2/b3 Subdeletion or Duplication to Expanded Y Chromosome Microdeletions.

    Pan Y, Li LL, Yu Y, et al.

    Medical science monitor : international medical journal of experimental and clinical research 2018; (24()):6559-6563 doi:10.12659/MSM.911644.

    PMID: 30226219
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    Increased Y Chromosome Microdeletions in Cord Blood of Male Newborns From Assisted Reproductive Technology Compared to Natural Conception.

    Ng R, Stanar P, Louie K, et al.

    Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC 2024; (46(4)):102342 doi:10.1016/j.jogc.2023.102342.

    PMID: 38176679
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    Precise exome analysis of blastocyst biopsy scale samples using primary template-directed amplification.

    Samitova A, Belova V, Vasiliadis I, et al.

    BMC genomics 2026; (27(1)).

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    Combining PGT-A with PGT-M risks trying to do too much.

    Scriven PN

    Journal of assisted reproduction and genetics 2022; (39(9)):2015-2018 doi:10.1007/s10815-022-02519-8.

    PMID: 35583570
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    Aneuploidy rates and likelihood of obtaining a usable embryo for transfer among in vitro fertilization cycles using preimplantation genetic testing for monogenic disorders and aneuploidy compared with in vitro fertilization cycles using preimplantation genetic testing for aneuploidy alone.

    Martel RA, Lee MB, Schadwell A, et al.

    Fertility and sterility 2024; (122(6)):993-1001 doi:10.1016/j.fertnstert.2024.07.030.

    PMID: 39069217
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    State-Mandated Insurance Coverage and Preimplantation Genetic Testing in the United States.

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    Obstetrics and gynecology 2022; (139(4)):500-508 doi:10.1097/AOG.0000000000004712.

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    Use of reproductive technology for sex selection for nonmedical reasons: an Ethics Committee opinion.

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    PMID: 35105444
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    THINK OF THE CHILDREN: SEX SELECTION AND CHILD WELFARE.

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    An analysis of Y-chromosome microdeletion in infertile Korean men with severe oligozoospermia or azoospermia.

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    Complete Azoospermia Factor b Deletion of Y Chromosome in an Infertile Male With Severe Oligoasthenozoospermia: Case Report and Literature Review.

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This page explains the genetic inheritance of Y chromosome microdeletions for educational purposes. Consult a genetic counselor or reproductive endocrinologist for advice regarding your specific IVF and embryo testing options.

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