Fertility in Ex-Cryptorchids: Study of 159 Cases

Abstract

The Authors report their experience in the fertility evaluation of 159 men who underwent, during childhood, orchiopexy for cryptorchidism. Patients were divided into two groups. Group A consisted of 67 patients out of 442 subjected to orchiopexy between 1975 and 1983. Group B consisted of 92 patients out of 1052 evaluated for infertility. All patients were evaluated by semen analysis, testis ultrasound, FSH, LH, Testosterone. The percentage of normospermic patients in Group A was 51.7% and in Group B 14.7% (p < 0.001). When bilateral cryptorchidism was present the percentage of semen anomalies was very high: 16.6% and 40% of azoospermia in Group A and B respectively. In patients with monolateral cryptorchidism the mean testicular volume of the undescended testis is significantly lower than the contralateral one. This latter fact only is related to sperm concentration and is inversely proportional to FSH value. In monolateral cryptorchidism the sperm concentration seems to be unrelated to previous treatment (orchiopexy vs orchiectomy). Even if the Authors cannot exclude the possibility of testicular damage due to late treatment, they point out the possibility of a primary testicular anomaly. The involvement of the contralateral normally-descended testis seems to confirm this possibility which needs, however, to be confirmed through a structural study.