As the field of assisted reproduction has advanced, many previously untreatable men are now biological fathers. Although finding sperm in men with obstructive azoospermia is not difficult, locating and retrieving sper...As the field of assisted reproduction has advanced, many previously untreatable men are now biological fathers. Although finding sperm in men with obstructive azoospermia is not difficult, locating and retrieving spermatozoa in men with non-obstructive azoospermia remains a clinical challenge, largely because sperm production in these men can be patchy or focal in nature. In response to this challenge, strategies such as fine-needle aspiration （FNA） mapping have been developed to find spermatozoa. This review discusses the history, evolution and current clinical utility and findings with FNA mapping for male infertility）. Review of the current literature in the English language on FNA （diagnostic or therapeutic） with a keyword focuses on sperm detection, retrieval, safety and complications. FNA was described in human medicine over 100 years ago. Testis FNA was described 45 years ago and FNA ＇mapping＇ of spermatozoa was described in 1997. This comparative review of the literature on sperm detection and complication rates with FNA and open testis biopsy or microdissection procedures suggests that FNA is highly informative, minimally invasive and is associated with fewer complications than other commonly used approaches to sperm detection in non-obstructive azoospermic patients. FNA mapping has gained considerable traction as an informative, ＇testis sparing＇ technique for sperm detection in non-obstructive azoospermia. With knowledge of sperm presence and location prior to sperm retrieval, FNA maps can help clinicians tailor sperm retrieval to optimize time, effort and extent of procedures needed to procure spermatozoa in these difficult cases.展开更多
While stock markets and economies are smoldering all over the world, stem cell science is on fire. The promise of curing many untreatable forms of human male infertility is now one small step closer based on a recent ...While stock markets and economies are smoldering all over the world, stem cell science is on fire. The promise of curing many untreatable forms of human male infertility is now one small step closer based on a recent paper in Cell. In this work, scientists from Kyoto University in Japan created mature, fertile sperm from embryonic and induced pluripotent stem cells by grabbing the primitive germ cells called primordial germ cells just as they were being made from their pluripotent precursors in vitro and transplanting them back into genetically sterile mice.展开更多
We sought to evaluate the ability of fine-needle aspiration (FNA)mapping to find sperm and to guide sperm retrieval after failed microdissection testicular sperm extraction (micro-TESE)in nonobstructive azoospermic me...We sought to evaluate the ability of fine-needle aspiration (FNA)mapping to find sperm and to guide sperm retrieval after failed microdissection testicular sperm extraction (micro-TESE)in nonobstructive azoospermic men.In this study of consecutive male infertility cases,interventions included testicular FNA mapping and subsequent sperm retrieval.Outcomes included the frequency and location of found sperm on FNA maps after failed micro-TESE and the salvage sperm retrieval success.Among 548 patients undergoing FNA mapping from 2010 to 2016,82 men with previous micro-TESE procedures were identified.The mean time between micro-TESE and FNA mapping was 2.2 years.A total of 2825 (1424 on right and 1401 on left)sites were mapped.At least one site revealed mature sperm in 24 (29.3%)of 82 men with prior failed micro-TESE procedures.There was an equal likelihood of detecting sperm in either testis (6.1%right;5.7%left;P=0.58).Digital "heat maps"revealed differences in sperm findings within the testis with mature sperm more likely found in the testis periphery rather than centrally.Fifteen (62.5%)patients subsequently underwent sperm retrieval procedures guided by FNA maps.Sufficient sperm were retrieved in all cases,and in 10 (66.7%)of 15 cases,extra sperm were frozen for future use.in a significant proportion of failed micro-TESE procedures representing the largest study to date,sperm were detected by FNA mapping and could be reliably retrieved through FNA map-guided surgical sperm retrieval.When present,sperm were more likely to be found in the testis periphery rather than centrally with FNA mapping.展开更多
文摘As the field of assisted reproduction has advanced, many previously untreatable men are now biological fathers. Although finding sperm in men with obstructive azoospermia is not difficult, locating and retrieving spermatozoa in men with non-obstructive azoospermia remains a clinical challenge, largely because sperm production in these men can be patchy or focal in nature. In response to this challenge, strategies such as fine-needle aspiration （FNA） mapping have been developed to find spermatozoa. This review discusses the history, evolution and current clinical utility and findings with FNA mapping for male infertility）. Review of the current literature in the English language on FNA （diagnostic or therapeutic） with a keyword focuses on sperm detection, retrieval, safety and complications. FNA was described in human medicine over 100 years ago. Testis FNA was described 45 years ago and FNA ＇mapping＇ of spermatozoa was described in 1997. This comparative review of the literature on sperm detection and complication rates with FNA and open testis biopsy or microdissection procedures suggests that FNA is highly informative, minimally invasive and is associated with fewer complications than other commonly used approaches to sperm detection in non-obstructive azoospermic patients. FNA mapping has gained considerable traction as an informative, ＇testis sparing＇ technique for sperm detection in non-obstructive azoospermia. With knowledge of sperm presence and location prior to sperm retrieval, FNA maps can help clinicians tailor sperm retrieval to optimize time, effort and extent of procedures needed to procure spermatozoa in these difficult cases.
文摘While stock markets and economies are smoldering all over the world, stem cell science is on fire. The promise of curing many untreatable forms of human male infertility is now one small step closer based on a recent paper in Cell. In this work, scientists from Kyoto University in Japan created mature, fertile sperm from embryonic and induced pluripotent stem cells by grabbing the primitive germ cells called primordial germ cells just as they were being made from their pluripotent precursors in vitro and transplanting them back into genetically sterile mice.
文摘We sought to evaluate the ability of fine-needle aspiration (FNA)mapping to find sperm and to guide sperm retrieval after failed microdissection testicular sperm extraction (micro-TESE)in nonobstructive azoospermic men.In this study of consecutive male infertility cases,interventions included testicular FNA mapping and subsequent sperm retrieval.Outcomes included the frequency and location of found sperm on FNA maps after failed micro-TESE and the salvage sperm retrieval success.Among 548 patients undergoing FNA mapping from 2010 to 2016,82 men with previous micro-TESE procedures were identified.The mean time between micro-TESE and FNA mapping was 2.2 years.A total of 2825 (1424 on right and 1401 on left)sites were mapped.At least one site revealed mature sperm in 24 (29.3%)of 82 men with prior failed micro-TESE procedures.There was an equal likelihood of detecting sperm in either testis (6.1%right;5.7%left;P=0.58).Digital "heat maps"revealed differences in sperm findings within the testis with mature sperm more likely found in the testis periphery rather than centrally.Fifteen (62.5%)patients subsequently underwent sperm retrieval procedures guided by FNA maps.Sufficient sperm were retrieved in all cases,and in 10 (66.7%)of 15 cases,extra sperm were frozen for future use.in a significant proportion of failed micro-TESE procedures representing the largest study to date,sperm were detected by FNA mapping and could be reliably retrieved through FNA map-guided surgical sperm retrieval.When present,sperm were more likely to be found in the testis periphery rather than centrally with FNA mapping.
