Pediatric Urology

Objectives: To investigate, in a prospectively randomized trial, whether preoperative gonadotropin-releasing hormone (GnRH) therapy improves the fertility index in primary cryptorchidism.Cryptorchidism is a common condition with a high risk of infertility.Treatment with GnRH appears to improve fertility later in life by inducing germ cell maturation.Methods: A total of 24 boys, 12-123 months old (median 34.5), with 24 undescended testes were prospectively assigned to 2 groups during a 24-month period.The patients were randomized to receive either orchiopexy alone (n = 12) or orchiopexy combined with neoadjuvant GnRH therapy (n = 12) as a nasal spray for 4 weeks at 1.2 mg/d.In both groups, testicular biopsies were performed at orchiopexy, and the histopathologic fertility index was determined.Results: The mean fertility index in the group treated with GnRH before surgery was significantly greater (0.88 +/-0.31)than in the group without hormonal stimulation (0.49 +/-0.52;P = .02).No significant correlation was found between the fertility index in the GnRH group and the patient's age.Conclusions: The results of our study have shown that neoadjuvant GnRH treatment improves the fertility index in prepubertal cryptorchidism and, consequently, should improve fertility in adulthood.

Abstract licence: CC BY

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