Acquired cryptorchidism is frequent in infancy and childhood

Wohlfahrt-Veje, Christine; Boisen, Kirsten A; Boas, Malene; Damgaard, Ida; Kai, Claudia Mau; Schmidt, Ida Maria; Chellakooty, Marla; Suomi, Anne-Maarit; Toppari, Jorma; Skakkebæk, Niels E.; Main, Katharina M.

doi:10.1111/j.1365-2605.2008.00946.x

Cited by 84 publications

(61 citation statements)

References 23 publications

(29 reference statements)

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“…This loss of statistical power is partly due to the smaller number of observations, but also to the fact that several of the excluded registries from Oceania or Canada have the highest rates reported among ICBDSR registries included in our analysis. These high rates may be partly due to the inclusion of the so-called acquired cryptorchidism cases (Acerini et al, 2009;Wohlfahrt-Veje et al, 2009), but may also be the result of a genuine greater incidence in these countries.…”

Section: Discussionmentioning

confidence: 99%

International geographic correlation study of the prevalence of disorders of male reproductive health

et al. 2013

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what is known already: Some associations between these outcomes have been shown in studies focusing on individuals and mainly in Nordic European countries. These associations, together with histological evidence of a dysgenesis pattern in testicular tissue specimens, have generated the concept of the existence of a 'testicular dysgenesis syndrome' originating in utero. study design, size, duration: This is a geographical correlation study using cancer, malformations rates and sperm quality data collected between the years 1998 and 2005.participants/materials, setting, methods: Incidence rates of testicular cancer were extracted from International Agency for Research on Cancer registries and Globocan, while cryptorchidism and hypospadias prevalence rates were obtained from EUROCAT and International Clearinghouse for Birth Defects Surveillance and Research registries. Sperm concentration data were extracted from recent studies using standardized methodology. A total of 39 registries and 9 sperm studies were selected. Non-parametric Spearman correlation tests were used to test the association between these four disorders. Correlations were computed for all registries together, for registries with high-quality matching coverage only and by continents. Sensitivity analyses were also conducted using data from prospective clinical studies to take into account potential bias related mainly to ascertainment of malformation rates.main results and the role of chance: We found positive correlations between testicular cancer and hypospadias (r ¼ 0.32, P ¼ 0.05) and between hypospadias and cryptorchidism (r ¼ 0.70, P ¼ 0.008). Stronger correlations were observed when using registries with high-quality matching coverage. Among these registries, differences between Europe and the rest of the world appeared (the positive correlation between testicular cancer and cryptorchidism was stronger outside Europe, r ¼ 0.83, P ¼ 0.01 compared with 0.40, P ¼ 0.60 for European registries). A negative correlation between testicular cancer and sperm concentration was observed (r ¼ 20.88, P ¼ 0.002). These correlations support our initial hypothesis but remain only suggestive due to the intrinsic limitations in the study design (i.e. geographical correlation study) and do not allow causal inference.limitations, reasons for caution: Differences in the ascertainment of malformations rates (definition, length of follow-up) make the international comparison difficult. The small number of registries for some conditions (cryptorchidism) or of studies (for sperm quality) and the absence of information about major risk factors such as ethnicity and socioeconomic status in the registries are also limitations.wider implications of the findings: Our findings are in agreement with results of studies focusing on individuals and suggest that shared risk factors are present in the populations studied. † These authors contributed equally to this work.

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Section: Discussionmentioning

confidence: 99%

International geographic correlation study of the prevalence of disorders of male reproductive health

et al. 2013

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“…[80][81][82][83] In male infants, crypt orchidism (that is, maldescended testes) and micropenis can be signs of GnRH deficiency (Figure 1), yet these features are by no means invariable. [84][85][86] As penile growth occurs during infancy and childhood, micropenis can be assessed using available cross-sectional normative data. 87,88 These two clinical clues warrant hormonal monitoring during mini-puberty.…”

Section: Clinical Presentation Of Chhmentioning

confidence: 99%

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

et al. 2015

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| Congenital hypogonadotropic hypogonadism (CHH) is a rare disorder caused by the deficient production, secretion or action of gonadotropin-releasing hormone (GnRH), which is the master hormone regulating the reproductive axis. CHH is clinically and genetically heterogeneous, with >25 different causal genes identified to date. Clinically, the disorder is characterized by an absence of puberty and infertility. The association of CHH with a defective sense of smell (anosmia or hyposmia), which is found in ~50% of patients with CHH is termed Kallmann syndrome and results from incomplete embryonic migration of GnRHsynthesizing neurons. CHH can be challenging to diagnose, particularly when attempting to differentiate it from constitutional delay of puberty. A timely diagnosis and treatment to induce puberty can be beneficial for sexual, bone and metabolic health, and might help minimize some of the psychological effects of CHH. In most cases, fertility can be induced using specialized treatment regimens and several predictors of outcome have been identified. Patients typically require lifelong treatment, yet ~10-20% of patients exhibit a spontaneous recovery of reproductive function. This Consensus Statement summarizes approaches for the diagnosis and treatment of CHH and discusses important unanswered questions in the field.

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“…26 The incidence varies between 2 and 9% at birth (with some geographical variations across Europe) and decreases to 1-2% by 3 months of age due to delayed spontaneous descent. [27][28][29] However, cryptorchidism is found not only as a congenital disorder, but also as an acquired disorder diagnosed during infancy and childhood. 29,30 The so called "acquired cryptorchidism" is defined as the ascent of the testis into a cryptorchid position after normal scrotal position at birth and its cumulative incidence by age 24 months can be even higher than that observed at birth (in the UK congenital forms have a prevalence of 5.7% while "acquired" forms 7%).…”

Section: Varicocelementioning

confidence: 99%

“…[27][28][29] However, cryptorchidism is found not only as a congenital disorder, but also as an acquired disorder diagnosed during infancy and childhood. 29,30 The so called "acquired cryptorchidism" is defined as the ascent of the testis into a cryptorchid position after normal scrotal position at birth and its cumulative incidence by age 24 months can be even higher than that observed at birth (in the UK congenital forms have a prevalence of 5.7% while "acquired" forms 7%). 31 The interaction of genetic and environmental (mainly endocrine disrupters) factors acting on the fetal testis has been proposed as the major determinant of the progressive increase during the past 50 years of pathologies such as cryptorchidism, testis cancer, hypospadia and impaired spermatogenesis in Western countries.…”

Section: Varicocelementioning

confidence: 99%