Group - FNA Mapping

Fine needle aspiration (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, it 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: 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. Another significant advance in ART was the development of intracytoplasmic sperm injection (ICSI) in 1992. Performed in conjunction with IVF, ICSI involves the injection of a single, viable sperm directly into the egg cytoplasm in vitro to facilitate fertilization in cases of low sperm numbers. ICSI has decreased the numerical sperm requirement for egg fertilization with IVF from hundreds of thousands of sperm for each egg to a single sperm. In addition, ICSI allows sperm with limited intrinsic fertilizing capacity, including “immature” sperm obtained from the reproductive tract of men with no sperm in the ejaculate to reliably fertilize eggs. Indeed, ICSI has become so popular that U.S. clinics have routinely used it in more than 56% of their IVF cases.