Fine-Needle Aspiration "Mapping" of Testes - Diagnosis of Male Infertility
Key points
- Although testicular sperm is used with IVF and ICSI to achieve pregnancies, there is a failure to obtain sperm in 25-50% of men with testis failure.
- Seminal fluid that passes through the urethra is routinely contaminated with bacteria.
- Like a testis biopsy, fine-needle aspiration procedure is performed under local anesthesia.
- When testis biopsies fail to retrieve sperm, IVF cycles are canceled at great emotional and financial cost.
Check (Figure 42-12)
Although testicular sperm is used with IVF and ICSI to achieve pregnancies, there is a failure to obtain sperm in 25-50% of men with testis failure. When testis biopsies fail to retrieve sperm, IVF cycles are canceled at great emotional and financial cost. To minimize the chance of failed sperm retrieval, percutaneous fine-needle aspiration and "mapping" of the testis has been described. This technique can detect sperm in 60% of men with nonobstructed azoospermia and has confirmed that spermatogenesis can vary geographically in the failing testis such that "pockets" of sperm can exist.
Like a testis biopsy, fine-needle aspiration procedure is performed under local anesthesia. Percutaneously aspirated seminiferous tubules from various locations in the testis (5-10 mg) are smeared on a slide, fixed, stained, and read by a cytologist for the presence or absence of sperm. The information gained from this technique can fully inform patients of their chances of subsequent sperm retrieval for IVF and ICSI.
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Written and revised by
David Cohen, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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