Early successful orchidopexy does not prevent from developing azoospermia

Abstract

The most severe cause of infertility in cryptorchid patients cannot be mitigated by an early successful surgery alone.

Cryptorchidie : de la physiopathologie à l’infertilité

“…Cela confirme l'hypothè se de l'existence de probables anomalies de la spermatogenè se au sein du testicule controlaté ral supposé « sain ». Actuellement, l'anté cé dent de cryptorchidie est une des principales é tiologies d'azoospermie (15 à 20 % des azoospermies) [91]. Le caractè re bilaté ral est là encore plus pé joratif puisque 46 % des patients infertiles ayant un anté cé dent de cryptorchidie bilaté rale pré sentent une azoospermie, alors que ce taux chute à 20 % dans le groupe des patients infertiles ayant un anté cé dent de cryptorchidie unilaté rale [92].…”

Effect of testis nondescent or orchidopexy on antisperm antibodies and testis histology in rats

“…Despite early operation performed today (3rd-19th month), infertility is not ameliorated (3). If ASA develop in adulthood, avoiding infertility-one of the goals of surgery-may not be achieved.…”

Antisperm Antibodies in Undescended Testis

“…In our study, unilateral undescended testis constitutes 73.3% and the rest was 26.6% bilateral and 80% were located in the superficial inguinal ring and 76.6% of them were associated with hernia. Other study found that bilateral cryptorchidism was 45% and the rest was unilateral [10]. Cendron et al documented the position of testis at the time of surgery and found that position at tubercle represent 42% and at inguinal canal was 12% [14].…”

“…This may be due to the impaired spermatogenesis that is characterized histologically in the first months of life by an increasing reduction in the testosterone-producing Leydig cells, delayed onset of spermatogonia, and a quantitatively and qualitatively reduced maturation process of the germ cells [9]. Another cause of infertility in those patients is development of antisperm antibodies (ASA) despite early operation performed between third to ninth months; infertility is not ameliorated [10]. Surgeon is often puzzled by postoperative development of ASA later on [11].…”