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  Genetic counselling and ICSI  
 
 
The best initial management is to give the couple full information about the risks to the child to help them decide whether or not to proceed with ICSI.
 
However, in the situation where both partners are known to carry defects (e.g. cystic fibrosis mutations), there can be up to a 50% chance of a child from the union developing clinical cystic fibrosis and dying early after a number of years of morbidity. Many clinicians and infertility clinic personnel may feel that their duty of care to the future child and the interests of society as a whole outweigh the wishes of the individual couple and that it is not ethical to proceed. When there is a conflict that cannot be resolved by agreement, the interests of a future child probably take precedence over the interests of a couple. Furthermore, the couple wiD need to give consideration to pre-implantation diagnosis and the replacement only of normal embryos