The Turek Clinic, 55 Francisco St. Suite 300, San Francisco, CA 94010, USA.
Asian J Androl. 2011 Mar;13(2):225-30. doi: 10.1038/aja.2010.178. Epub 2011 Jan 24.
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.
随着辅助生殖领域的发展，许多以前无法治疗的男性现在已经成为了生物学意义上的父亲。虽然在梗阻性无精子症男性中找到精子并不困难，但在非梗阻性无精子症男性中定位和获取精子仍然是一个临床挑战，主要是因为这些男性的精子生成可能具有局灶性或斑片状的特征。针对这一挑战，已经开发了一些策略，如细针抽吸（FNA）图谱，以寻找精子。本文回顾了 FNA 图谱在男性不育症中的历史、发展和目前的临床应用和发现。回顾了英语文献中关于 FNA（诊断或治疗）的当前文献，重点关注精子检测、获取、安全性和并发症。FNA 在 100 多年前的人类医学中就有描述。睾丸 FNA 在 45 年前被描述，而精子的 FNA 图谱则在 1997 年被描述。本文对 FNA 和开放睾丸活检或微切割术检测精子的文献进行了比较性回顾，结果表明 FNA 高度信息丰富、微创，与其他常用于非梗阻性无精子症患者精子检测的方法相比，并发症较少。FNA 图谱作为一种信息丰富的、“保睾”技术，在非梗阻性无精子症中精子检测方面得到了广泛的关注。在进行精子获取之前了解精子的存在和位置，FNA 图谱可以帮助临床医生根据需要定制精子获取方案，以优化时间、努力程度和程序范围，从而在这些困难的情况下获取精子。
