Endocrine and Immunological Findings in Cryptorchid Infants

Abstract

In cryptorchid infants, significantly decreased mean levels of plasma testosterone and luteinizing hormone (LH) were found between the ages of 30 and 120 days. The levels of testosterone and LH were significantly correlated. No significant difference was found between infants with bilateral or unilateral cryptorchidism. After 120 days there was no longer any significant difference between cryptorchid infants and controls. No significant change in plasma follicle-stimulating hormone (FSH) was found. These data suggest that subnormal secretion of LH could be the primary abnormality in a proportion of boys with so-called common cryptorchidism. Our studies using LH-releasing hormone and human chorionic gonadotropin stimulation tests in older infants and children agree with the data obtained by measurement of basal plasma hormone levels during the first months of life. Anti-gonadotroph antibodies were found in the sera of approximately 50% of the cryptorchid children and infants studied, using an immunofluorescence technique. A study of 17 mothers and their infants gave concordant results in 16 pairs, 9 with and 7 without antibodies. This leads us to speculate on the possible role of maternal autoantibodies as a cause of partial gonadotrophin deficiency in the perinatal period and thus of testicular maldescent. As cryptorchidism is a syndrome, these findings do not mean that a similar mechanism is operative in all cases. However, these data do suggest that alternatives to the classical anatomical view of the descent and nondescent of the testes should be considered.

Genetics and Hormones in Testicular Descent

“…Raivio et al 9 reported that androgen bioactivity at 3 months of age correlated with serum testosterone concentration and cryptorchid boys had reduced androgen bioactivity. In some studies, decreased serum testoterone levels together with reduced luteinizing hormone (LH) levels have been found 10,11 . The androgen effect is necessary but not sufficient alone for normal testicular descent.…”

Environmental effects on hormonal regulation of testicular descent

“…Decreased serum testosterone and LH levels have been reported in some studies [32,33] but endocrine abnormalities are not always detected. In our study, a clear pattern of hormonal changes was seen in Finnish cryptorchid boys [31].…”

A novel mutation in the anti-müllerian hormone gene as cause of persistent müllerian duct syndrome

“…Serum levels of AMH are normal in neonates with cryptorchidism but are lower than normal at 4±12 months of age [1]. Also steroidogenesis, which is normal at birth in babies with cryptorchidism [3,8], can become deranged within a few months after birth [3]. In both our patients, no evidence of testicular endocrine dysfunction was present at the time of diagnosis, as con®rmed by the hCG stimulation test and, clinically more important, by the spontaneous onset of puberty in our older patient.…”