Fertility Prospects for Children With Cryptorchidism

Gilhooly, Patricia; Meyers, Fred; Lattimer, John K.

doi:10.1016/s0022-5347(17)49302-5

Cited by 8 publications

(10 citation statements)

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“…3 ). Our observation explains the findings of Gilhooly et al [1984] of 2 different subsets of unilaterally cryptorchid boys: one with normal spermatogenic potential and the other exhibiting germinal deficiency unresponsive to surgical treatment in both testes. Correlations between testicular histology and postpubertal hormone levels confirmed a relative gonadotropin deficiency in the majority of adult cryptorchid men [Hadziselimovic and Hoecht, 2008].…”

Section: The Physiological Meaning Of Mini-pubertysupporting

confidence: 73%

Molecular Pathology of Cryptorchidism-Induced Infertility

Docampo¹,

Hadžiselimović²

2015

Sex Dev

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Cryptorchidism is the most common cause of non-obstructive azoospermia in man. In contrast to the general belief that temperature-dependent effects on the undescended gonad damage cryptorchid testes before sexual maturation is complete, molecular pathology strongly supports the theory that impaired mini-puberty is responsible for azoospermia and infertility in cryptorchidism. Molecular biological observations favor LH deficiency, with EGR4 as a master regulatory gene in Leydig cell dysgenesis, as the reason for impaired mini-puberty, and recent evidence supports the idea that infertility in cryptorchidism is a consequence of alterations in the Piwi pathway.

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Section: The Physiological Meaning Of Mini-pubertysupporting

confidence: 73%

Molecular Pathology of Cryptorchidism-Induced Infertility

Docampo¹,

Hadžiselimović²

2015

Sex Dev

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“…Four studies were judged good quality, 27,45,49,52 1 fair quality, 32 and the remainder poor quality. [28][29][30][31][33][34][35][36][37][38][39][40][42][43][44][46][47][48]50,51,53 Eleven studies reported outcomes after either 1-stage FS orchiopexy, 2-stage FS orchiopexy, or primary orchiopexy. [36][37][38][39][40][42][43][44][45]47,48 Nine of these studies, all retrospective cohorts, provided success rates by surgical procedure, although the choice of surgical method is made clinically and not with the intent of comparative effectiveness.…”

Section: Effectiveness Of Surgical Proceduresmentioning

confidence: 99%

Effectiveness of Hormonal and Surgical Therapies for Cryptorchidism: A Systematic Review

Penson¹,

Krishnaswami²,

Jules

et al. 2013

Pediatrics

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BACKGROUND AND OBJECTIVE: Controversy remains concerning the optimal treatment approach for cryptorchidism. The objective of this study was to assess effectiveness of hormone therapy or surgery for cryptorchidism. METHODS: We searched Medline and other databases from 1980 to February 2012. Two reviewers independently assessed studies against predetermined criteria. Two reviewers independently extracted data and assigned overall quality and strength of evidence ratings using predetermined criteria. RESULTS: Fourteen studies addressed effectiveness of hormonal treatments, and 26 studies addressed surgical intervention outcomes. Hormonal treatment is associated with testicular descent in some children, but rates generally do not exceed those seen with placebo by >10%. Surgical treatment is associated with success rates of testicular descent ranging from 33% to 100%, depending on surgery. Weighted success averages were 78.7% for 1-stage Fowler-Stephens (FS), 86% for 2-stage FS, and 96.4% for primary orchiopexy. Descent rates were similar among studies comparing laparoscopic and open surgeries. Reported harms of hormonal treatments were mild and transient. Adverse effects specifically associated with surgical repair were rare. CONCLUSIONS: The body of the reviewed literature comprises primarily fair- and poor-quality studies, limiting our ability to draw definitive conclusions. Hormonal treatment is marginally effective relative to placebo but is successful in some children and with minimal harms, suggesting that it may be an appropriate trial of care for some patients. Surgical options are effective, with high rates of testicular descent (moderate strength of evidence for FS procedures, high for primary orchiopexy). Comparable outcomes occur with laparoscopic and open approaches.

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“…The paternity rate in men who have undergone prepubertal treatment of unilateral cryptorchidism is 65070-80070 and that in men treated for bilateral cryptorchidism is 5007o-60070 [23,30] as compared with 8507o in the normal adult male population.…”

Section: Cryptorchidismmentioning

confidence: 99%

Preventable causes of male infertility

Thompson

1993

World J Urol

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The initial evaluation of the infertile man includes a diligent search for testicular factors, gonadotoxins, and coital factors so as to identify existing causes of impaired fertility and to prevent further dimunition in fertility. There are also prophylactic measures in the treatment of all men that can prevent future infertility, such as prompt correction of cryptorchidism, testicular torsion, genital infection, and adolescent varicocele and proper precautions to limit occupational, medical, and recreational gonadotoxins.

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Fertility Prospects for Children With Cryptorchidism

Abstract: \s=b\One hundred forty-five men had undergone surgical correction of cryptorchid testes between 1936 and 1968.

Cited by 8 publications

References 0 publications

Molecular Pathology of Cryptorchidism-Induced Infertility

Molecular Pathology of Cryptorchidism-Induced Infertility

Effectiveness of Hormonal and Surgical Therapies for Cryptorchidism: A Systematic Review

Preventable causes of male infertility

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