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. 2022 Mar;207(3):701-709.
doi: 10.1097/JU.0000000000002344. Epub 2021 Nov 26.

Low Serum Inhibin B/Follicle-Stimulating Hormones and Anti-Müllerian Hormone/Follicle-Stimulating Hormones Ratios as Markers of Decreased Germ Cells in Infants with Bilateral Cryptorchidism

Taiki Kato  1 , Kentaro Mizuno  2 , Daisuke Matsumoto  3 , Hidenori Nishio  2 , Akihiro Nakane  4 , Satoshi Kurokawa  3 , Hideyuki Kamisawa  3 , Tetsuji Maruyama  1 , Shoichiro Iwatsuki  3 , Yukihiro Umemoto  5 , Takahiro Yasui  3 , Yutaro Hayashi  2
Affiliations

Low Serum Inhibin B/Follicle-Stimulating Hormones and Anti-Müllerian Hormone/Follicle-Stimulating Hormones Ratios as Markers of Decreased Germ Cells in Infants with Bilateral Cryptorchidism

Taiki Kato et al. J Urol. 2022 Mar.

Abstract

Purpose: In cryptorchidism, germ cell development failure presents from infancy and may be reflected by altered hormonal levels produced by Sertoli cells. Our object was to assess for associations between serum hormone levels and testicular histopathology in cryptorchidism with an infertility risk according to the pretreatment undescended testicular positions.

Materials and methods: Prepubertal cryptorchid boys aged 7-91 (median 20) months who underwent orchidopexy between 2014 and 2019 were included (122 unilateral [median 19 months {range 7-91}], 23 bilateral [24 months {11-81}]). We evaluated the pretreatment testicular position and size; serum hormone levels; and the mean number of germ cells per tubule transverse section (G/T). We also performed a subgroup analysis of boys aged ≤24 months at orchidopexy.

Results: Serum inhibin B levels and G/T were significantly lower in bilateral than in unilateral cryptorchid boys (median 96 [range 46-197] pg/ml vs 125 [21-354] pg/ml, p=0.026; 0.20 [0-2.59] vs 0.65 [0-4.55], p <0.001, respectively). Inhibin B/follicle-stimulating hormones (FSH) and anti-Müllerian hormone (AMH)/FSH ratios were positively correlated with G/T in bilateral cryptorchid boys aged ≤24 months (12, p=0.008 and p=0.019, respectively). Low inhibin B/FSH and AMH/FSH ratios and high FSH were predictors of impaired G/T as per receiver operating characteristic curves (p=0.019, p=0.004 and p=0.004, respectively), whereas in unilateral cryptorchid boys aged ≤24 months, serum hormone levels and G/T did not differ with the pretreatment testicular positions.

Conclusions: In bilateral cryptorchid boys aged ≤24 months at orchidopexy, low inhibin B/FSH and AMH/FSH ratios may reflect impaired G/T and future infertility risk.

Keywords: Sertoli cells; cryptorchidism; follicle stimulating hormone; infertility, male; inhibins.

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Conflict of interest statement

Conflict of Interests: None.

Figures

Figure 1.
Figure 1.
Patient inclusion and exclusion flow chart.
Figure 2.
Figure 2.
Germ cells in seminiferous tubules were peripherally identified by staining with DEAD box protein 4 antibody (bar=40 μm). Inset shows enlarged view.
Figure 3.
Figure 3.
Comparison of diagnostic significance of serum hormones levels and ratios to predict lower limit of normal range of mean number of germ cells per tubule transverse section (G/T <0.4) in bilateral cryptorchid boys aged ≤24 months at orchidopexy. ROC curves derived from all patients depicting G/T <0.4 to predict later male infertility. A, Inhibin B/FSH. B, AMH/FSH. C, FSH. D, LH. E, inhibin B. F, AMH. p <0.05 was considered statistically significant.
See this image and copyright information in PMC

Comment in

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