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Concept
FNA Mapping
Résumé
FNA mapping is an application of fine-needle aspiration (FNA) to the testis for the diagnosis of male infertility. FNA cytology has been used to examine pathological human tissue from various organs for over 100 years. As an alternative to open testicular biopsy for the last 40 years, FNA mapping has helped to characterize states of human male infertility due to defective spermatogenesis. Although recognized as a reliable, and informative technique, testis FNA has not been widely used in U.S. to evaluate male infertility. Recently, however, testicular FNA has gained popularity as both a diagnostic and therapeutic tool for the management of clinical male infertility for several reasons:
The testis is an ideal organ for evaluation by FNA because of its uniform cellularity and easy accessibility.
The trend toward minimally invasive procedures and cost-containment views FNA favorably compared to surgical testis biopsy.
The realization that the specific histologic abnormality observed on testis biopsy has no definite correlation to either the etiology of infertility or to the ability to find sperm for assisted reproduction.
Assisted reproduction has undergone dramatic advances such that testis sperm are routinely used for biological pregnancies, thus fueling the development of novel FNA techniques to both locate and procure sperm.
For these reasons, there has been a resurgence of FNA as an important, minimally invasive tool for the evaluation and management of male infertility.
Advances in assisted reproductive technology (ART) have revolutionized the ability to help men with even the severest forms of male infertility to become fathers. This field began in earnest in 1978 when the first successful in vitro fertilization (IVF) cycle was performed. This technique involves controlled ovarian stimulation followed by egg retrieval, in vitro fertilization, and embryo transfer to the uterus. In the United States, the number of babies born to infertile couples with IVF has risen logarithmically from 260 babies in 1985 to almost 50,000 in 2003.
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