The Epidemiology of Cryptorchidism: Results from the John Radcliffe Hospital Cryptorchidism Study

Chilvers, Clair; Coupland, Carol; Ansell, Pat; Bennett, Vernon; Bull, Diana; Jackson, Matthew J.; Pike, Laura; Pike, Malcolm C.; Dudley, N. E.; Gough, Martin; Griffiths, D.M.; Redman, C. W. G.; Wilkinson, A; Macfarlane, Aidan

doi:10.1016/b978-0-08-042198-8.50010-8

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“…In the numerous studies of semen analysis from men after cryptorchidism, there is considerable variation in the percentage of patients with azoospermia and oligospermia (31)(32)(33)(34)(35)(36)(37)(38)(39). In an analysis of 27 published studies, the percentages of patients with azoospermia or oligospermia have been shown to be roughly similar for the groups that had surgical treatment, hormonal treatment, or combinations of both (34).…”

Section: Discussionmentioning

confidence: 99%

“…In an analysis of 27 published studies, the percentages of patients with azoospermia or oligospermia have been shown to be roughly similar for the groups that had surgical treatment, hormonal treatment, or combinations of both (34). Unsuccessful hCG treatment followed by orchidopexy, however, seems to result in a higher prevalence of azoospermia than orchidopexia alone (56% compared with 42%, respectively) (34).…”

Section: Discussionmentioning

confidence: 99%

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Germ cell apoptosis after treatment of cryptorchidism with human chorionic gonadotropin is associated with impaired reproductive function in the adult.

Dunkel¹,

Taskinen²,

Hovatta³

et al. 1997

J. Clin. Invest.

149

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Cryptorchidism results in impaired fertility. Reduced numbers of testicular germ cells can be shown histologically during the first years of life. The process causing germ cell loss in cryptorchid prepubertal boys is unknown, but it could be the result of a form of programmed cell death known as apoptosis. 25 adult men with a history of surgically treated cryptorchidism were studied, 15 of whom had received an unsuccessful human chorionic gonadotropin (hCG) therapy before orchidopexy. Apoptotic DNA fragmentation was assayed in testis biopsies taken during orchidopexy by endlabeling, both in extracted DNA and histochemically in situ. Only a few scattered apoptotic spermatogonias were seen by end-labeling of biopsies from patients not treated with hCG, whereas more extensive labeling of spermatogonia was seen after hCG treatment. As estimated by gel electrophoresis, the amount of low molecular weight DNA was 4.3-fold higher in the hCG-treated group when compared with the level in scrotal testis of non-hCG-treated patients ( P Ͻ 0.001). About 20 yr after the biopsy, the low molecular weight DNA fragmentation correlated negatively with the testis volume ( r ϭ Ϫ 0.84; P Ͻ 0.001) and positively with serum FSH levels ( r ϭ 0.73; P Ͻ 0.001). Findings in the semen analysis were similar between the groups. Apoptotic loss of spermatogonia after hCG treatment of cryptorchidism warrants reevaluation of the safety of this treatment. ( J. Clin. Invest.

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