A phenotypically normal male who fathered a son with the karyotype 46,XY,del(10)(p13) was found to be a balanced carrier of an inverted insertion (3;10) (q13.2;p14p13). Karyotyping five later pregnancies showed four to be unbalanced with respect to the insertion, one of which was also trisomic for chromosome 18. The latest pregnancy was balanced with respect to insertion but had the additional complexity of 47,XXY. In the light of six out of six chromosomally abnormal pregnancies, two of which potentially exhibit an interchromosomal effect, it was decided to investigate the gametic output of the father. Testicular biopsy and semen samples were obtained permitting both meiotic and sperm chromosome analysis. Information was thus obtained at three levels of gamete production, that is, prophase I pairing, chiasma frequency distribution at metaphase I, and sperm karyotypes. Electron microscope studies of synaptonemal complexes showed the rearranged chromosomes to pair fully in meiotic prophase I with no indication of the presence of an insertion. This non-homologous pairing of the inserted region was accompanied by an abnormal frequency distribution of pachytene substages. There was also a reduction in chiasma frequency throughout the genome. However, this did not lead to detectable autosomal univalence or abnormally high X/Y univalence. Thus, the trisomy 18 and XXY pregnancies are unlikely to reflect increased non-disjunctional rates either before or during the first meiotic division. Sperm karyotyping showed that the proportion of chromosomally balanced:unbalanced gametes did not differ from the theoretically expected 1:1. There was no evidence of any increase of unrelated abnormalities in the sperm, further indicating that the overall rate of meiotic non-disjunction was not increased above normal.

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