No Relationship of Testicular Size at Orchiopexy With Fertility in Men Who Previously Had Unilateral Cryptorchidism

LEE, PETER A.; Coughlin, Michael T.; Bellinger, Mark F.

doi:10.1097/00005392-200107000-00072

Cited by 25 publications

(31 citation statements)

References 16 publications

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“…In line with these preliminary findings, low inhibin B levels are found in a large portion of formerly cryptorchid men who show compromised seminiferous tubule function (15). Preoperative testicular location (16) or testicular size at orchidopexy (17) in men with previous unilateral cryptorchidism was not a major determinant of inhibin B levels, whereas early operation appears to be beneficial. Thus, adult men with a history of cryptorchidism and who underwent orchiopexy by the age of 2 years have higher inhibin B levels compared with those who underwent surgery later in life (18).…”

Section: Introductionsupporting

confidence: 73%

Serum inhibin B, FSH, LH and testosterone levels before and after human chorionic gonadotropin stimulation in prepubertal boys with cryptorchidism

Christiansen

Andersson²,

Ne³

et al. 2002

Eur J Endocrinol

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Background: Several studies have indicated that cryptorchidism is associated with degenerative changes in both Sertoli cells and germ cells. The gonadal peptide hormone inhibin B reflects Sertoli cell function. Low inhibin B levels are found in a large portion of formerly cryptorchid men who show compromised seminiferous tubule function. It is not known if inhibin B can be used to demonstrate early damage of seminiferous tubules in prepubertal boys with cryptorchidism. Methods: We investigated the relationship between serum levels of inhibin B, testosterone, FSH and LH in 62 prepubertal boys with uni-and bilateral cryptorchidism. Furthermore, we investigated the changes in serum levels of inhibin B and the corresponding changes in serum levels of FSH, LH and testosterone during a short course (3 weeks) of human chorionic gonadotropin (hCG) injections in 18 of these cryptorchid boys. Results: In the 62 prepubertal boys with uni-or bilateral cryptorchidism there were no significant differences in baseline levels (median and range) of inhibin B (88 (20-195) pg/ml vs 78 (35-182) pg/ml; not significant), LH (0.08 (,0.05 -0.99) IU/l vs 0.06 (,0.05 -1.61) IU/l; not significant) and FSH (0.60 (0.08-3.73) IU/l vs 0.85 (0.25 -2.55); not significant) compared with 156 healthy prepubertal boys, and there were no differences in hormonal levels between boys with unior bilateral cryptorchidism. There was no correlation between baseline levels of inhibin B and FSH. In boys younger than 9 years, we found no correlation between baseline levels of inhibin B and LH whereas, in boys older than 9 years, baseline levels of inhibin B were positively correlated to baseline LH (Spearman rank correlation coefficient ððR s Þ ¼ 0:58; P ¼ 0:03Þ: Treatment with hCG (1500 IU intramuscularly twice weekly for 3 weeks) resulted in descensus of testes in 9 out of 18 patients. In all boys but one, irrespective of age, hCG induced a marked increase in testosterone into the adult range (from undetectable to 21.8 (7.0 -35.4) nmol/l; P , 0:001) and completely suppressed FSH and LH levels. Serum levels of inhibin B increased significantly from 116 (50 -195) pg/ml to 147 (94 -248) pg/ml ðP , 0:05Þ; but not uniformly. The increase in serum levels of inhibin B was inversely correlated to baseline inhibin B ðRs ¼ 20:52; P ¼ 0:03Þ and baseline FSH ðR s ¼ 20:59; P , 0:01Þ: Conclusions: We therefore suggest that, in the prepubertal testes, inhibin B is secreted from the prepubertal Sertoli cells following hCG, whereas early pubertal testes with more differentiated Sertoli cells are not able to secrete inhibin B in response to hCG stimulation, perhaps due to lack of germ cell-derived bB-subunits. We found (a) normal inhibin B levels in prepubertal boys with uni-or bilateral cryptorchidism, (b) that hCG stimulated testosterone markedly and suppressed FSH and LH levels and (c) that hCG treatment stimulated inhibin B levels in the youngest cryptorchid boys. In the oldest prepubertal boys no hCG-induced changes in inhibin B were shown.

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Section: Introductionsupporting

confidence: 73%

Serum inhibin B, FSH, LH and testosterone levels before and after human chorionic gonadotropin stimulation in prepubertal boys with cryptorchidism

Christiansen

Andersson²,

Ne³

et al. 2002

Eur J Endocrinol

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“…In the patients from our study, the FSH serum levels did not show differences between the groups. Similar results were obtained by others [6,13,14].…”

Section: Discussionsupporting

confidence: 92%

Surgical vs. Untreated Cryptorchidism: Effects on Fertility

Gómez‐Pérez

Osuna

Arata-Bellabarba

2004

Archives of Andrology

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Forty-four patients with history of cryptorchidism were studied: 15 untreated (group A); 14 treated by orchiopexy at age 4.5 AE 1.4 years (group B), and 15 with unilateral orchiectomy of undescended testis at 8.4 AE 1.6 years (group C). Testicular volume, semen analysis, and LH and FSH were measured. Normal sperm counts were noted in 53%, 36% and 47% of patients in groups A, B and C, respectively. FSH and LH serum levels showed no differences between the groups. Testicular volume of the normal descended testes showed no differences between the three groups. Positive correlation was obtained between testicular volume=sperm concentration and negative correlation between gonadotropins=sperm concentration. The remaining testicular volume and gonadotropin serum values from adults with history of chryptorchidism who underwent orchiectomy were not different from those orchiopexied treated nor with untreated patients. The percentage of men with sperm count greater than 20 millions=mL was lower in the orchiopexied men compared to A and C groups. There seems to be different etiologic factors in our patients.

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“…Lee et al [35] found no correlation with size at the time of orchidopexy and future fertility. Also, Noh et al [13] showed that testis volume does not accurately predict the germ cell count.…”

Section: Discussionmentioning

confidence: 96%

A comparison of palpable and impalpable cryptorchid testes using CD‐99 immunohistochemistry

et al. 2003

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tubule (MGCT) were calculated using immunohistochemistry for CD-99, a Sertolicell marker, to classify germ cells more accurately. RESULTSSixty-three testes (33%) were impalpable; the median age at the time of surgical exploration was 23 months for both groups. The mean ( SD ) testicular volume for the impalpable and palpable groups were 0.83 (0.38) and 1.22 (0.54) mL, respectively. Using fitted curves of size vs age, impalpable testes were smaller than palpable testes at all ages, with the difference nearly statistically significant ( P < 0.06). The MTD, TFI and MGCT decreased with age in both groups, with no statistically significant differences between the groups. A sub-analysis of abdominal and extraabdominal testes confirmed no significant differences. CONCLUSIONImpalpable testes are smaller at the time of exploration than palpable cryptorchid testes. However, histological factors predict that impalpable testes have a significant chance of future fertility and therefore orchidopexy is appropriate. CD-99 immunohistochemistry makes objective morphological information easier to obtain.

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No Relationship of Testicular Size at Orchiopexy With Fertility in Men Who Previously Had Unilateral Cryptorchidism

Abstract: In men with a history of unilateral cryptorchidism small testicular size at orchiopexy is not associated with decreased paternity (89.8%), abnormal hormone levels, a lower sperm count or decreased testicular volume in adulthood.

Cited by 25 publications

References 16 publications

Serum inhibin B, FSH, LH and testosterone levels before and after human chorionic gonadotropin stimulation in prepubertal boys with cryptorchidism

Serum inhibin B, FSH, LH and testosterone levels before and after human chorionic gonadotropin stimulation in prepubertal boys with cryptorchidism

Surgical vs. Untreated Cryptorchidism: Effects on Fertility

A comparison of palpable and impalpable cryptorchid testes using CD‐99 immunohistochemistry

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