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In cryptorchid boys, failures in germ cell development have been clearly established. Some studies reported some abnormalities in Sertoli cells morphology but the results regarding their endocrine secretion remain controversial. To compare testicular hormone levels in young boys with and without cryptorchidism, we performed a cross-sectional hospital-based study. From surgery appointment records, we identified a case group of boys with unilateral or bilateral cryptorchidism and a control group undergoing dental care, minor osteoarticular or dermal surgery. Blood samples were withdrawn during the surgical procedure to perform testosterone, inhibin B and anti-müllerian hormone (AMH) immunoassays. We included 27 cryptorchid boys and 27 controls aged of 26.6 vs. 24.2 months, respectively (p = 0.172) far from the post-natal mini-puberty and the corresponding hormonal surges. Age-adjusted AMH and inhibin B levels were significantly lower in cryptorchid than in control boys (AMH: 87 ng/mL vs. 135 ng/mL; p = 0.009, inhibin B: 97 pg/mL vs. 133 pg/mL; p = 0.019, respectively). Moreover, AMH and inhibin B levels were significantly lower in the bilateral cryptorchid subgroup, being 50% lower than in the controls (p = 0.011 and 0.019, respectively) and while both hormones levels were independent in controls, they became strongly correlated in bilateral cryptorchid boys (R² = 0.75, p = 0.001). In addition, testosterone levels were still detectable in some boys, with significantly lower levels in cryptorchid group than in controls. Overall, 2-year-old cryptorchid patients presented a simultaneous and significant drop in AMH and inhibin B levels, suggesting a functional defect of Sertoli cells. This deficiency appeared more pronounced in bilateral cryptorchidism and thus, regarding the pivotal role of Sertoli cells in germ cell development, it may explain the compromised fertility found later in men born with such a malformation., (© 2017 American Society of Andrology and European Academy of Andrology.)

The usual testicular location, either low or high in the scrotum, as well as testis ascent into suprascrotal position at least once a week from a usually scrotal position reported by the patient to occur spontaneously and regularly, were recorded in 85 fertile and 1014 infertile men, including 95 with a history of cryptorchism. The frequency of at least one testis being in a high scrotal location was similar in fertile (16.5%) and non-cryptorchid infertile (17%) men but higher in previously cryptorchid infertile men (27.2%), a difference probably due to cryptorchism. Testicular ascent was more frequent when scrotal location was high rather than low. An ascending testis was encountered more frequently in previously cryptorchid (30.4%) than in non-cryptorchid infertile men without any history of cryptorchism (18.3%) or in fertile men (11.8%). Moreover, in infertile men, spermatogenesis was more depressed in cases of testicular ascent than when both testes were never ascending, independently of a varicocele. Testis ascent could be a risk factor for spermatogenesis in infertile men without any history of maldescended testicle.

Out of 85 fertile and 1014 infertile men, two (2.4%) and 95 (9.4%) respectively had a history of cryptorchidism. Thus cryptorchidism appears to be a risk factor for fertility since this difference was significant. Further comparisons showed that the volume of a former cryptorchid testis was smaller than the contralateral normally descended one and that sperm output/concentration was more impaired in bilateral than in unilateral cryptorchidism. A retractile testis, defined as a testis reported by the patient to be spontaneously and regularly, i.e. at least once a week, ascending up into a supra-scrotal position, was more frequent in infertile men with a history of cryptorchidism than in fertile men. Retractility was more frequent on the cryptorchid side, and was found more frequently after hormonal than after surgical treatment. Independently of all epidemiological and clinical parameters studied, retractility was associated with a lower sperm output. Among the infertile men with a history of cryptorchidism, 45% had an abnormally high scrotal temperature. This abnormal temperature represented a pejorative risk factor for fertility in this group, since it was associated with a more severely impaired spermatogenesis and a higher incidence of primary infertility than in infertile men with a history of cryptorchidism but normal scrotal temperatures.

Temperature of the undescended testis, measured in its cryptorchid location during surgical procedure for orchidopexy in 46 boys, 13- to 180-months-old, was significantly higher (34.4 +/- 0.9 degrees C) than that of the contralateral normally descended testicle (33.2 +/- 1.2 degrees C; P < 0.001). Temperature significantly declined from the Bogros' space (35.3 +/- 0.5 degrees C) to the inguinal canal (34.7 +/- 0.7 degrees C) and from the latter to the empty scrotal cavity (31.1 +/- 1.8 degrees C). The physiological descent of the testicle is associated with a marked cooling of its thermal environment. When this process is interrupted for any reason, temperature of the cryptorchid testis is significantly increased. This rise in temperature could be either a concomitant or a main factor for the impairement of testicular functions associated with cryptorchidism.

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Out of 85 fertile and 1014 infertile men, two (2.4%) and 95 (9.4%) respectively had a history of cryptorchidism. Thus cryptorchidism appears to be a risk factor for fertility since this difference was significant. Further comparisons showed that the volume of a former cryptorchid testis was smaller than the contralateral normally descended one and that sperm output/concentration was more impaired in bilateral than in unilateral cryptorchidism. A retractile testis, defined as a testis reported by the patient to be spontaneously and regularly, i.e. at least once a week, ascending up into a supra-scrotal position, was more frequent in infertile men with a history of cryptorchidism than in fertile men. Retractility was more frequent on the cryptorchid side, and was found more frequently after hormonal than after surgical treatment. Independently of all epidemiological and clinical parameters studied, retractility was associated with a lower sperm output. Among the infertile men with a history of cryptorchidism, 45% had an abnormally high scrotal temperature. This abnormal temperature represented a pejorative risk factor for fertility in this group, since it was associated with a more severely impaired spermatogenesis and a higher incidence of primary infertility than in infertile men with a history of cryptorchidism but normal scrotal temperatures. [ABSTRACT FROM PUBLISHER]