Successful treatment of unilateral cryptorchid boys risking infertility with LH-RH analogue
Int. braz. j. urol
; 34(3): 319-328, May-June 2008. graf, tab
Article
en En
| LILACS
| ID: lil-489591
Biblioteca responsable:
BR1.1
ABSTRACT
INTRODUCTION:
Infertility is the primary concern for boys with uni- or bilateral undescended testes. An early and seemingly successful orchiopexy does not improve fertility in a substantial number of cryptorchid males. We confirmed that LH-RH analogue (LH-RHa) treatment induces an increase in and maturation of the germ cells; however, it was uncertain if treatment would improve the chance of fertility later in life. MATERIALS ANDMETHODS:
Thirty unilateral cryptorchid boys, with an average age of 3 years at the time of surgery, were included in the study. Testicular biopsy showed that they had impaired testicular maturation and were therefore at high risk for infertility. Fifteen of the 30 unilateral cryptorchid boys were treated with 10 µg LH-RHa (Buserelin) nasal spray, administered on alternate days for a period of 6 months, following orchiopexy. The control group consisted of 15 cryptorchid boys who had been treated by Schoemakers type of orchiopexy, alone. After puberty, the ejaculates of both groups were analyzed.RESULTS:
All males in the untreated group were severely oligospermic, with 20 percent being azoospermic. In contrast, 86 percent of the treated ex-cryptorchid males had a sperm concentration within the normal range; this was significantly different from the sperm concentration found in the untreated group (p = 0.000008).CONCLUSION:
For the first time, we demonstrate that infertility in cryptorchidism can be successfully corrected when suitably treated with a LH-RHa. Sperm parameters normalized following therapy in the majority of cryptorchid males who, untreated, would have remained infertile. This innovative hormonal treatment will have a profound effect on the current recommended surgical treatment of boys with undescended testes.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
LILACS
Asunto principal:
Recuento de Espermatozoides
/
Hormona Liberadora de Gonadotropina
/
Buserelina
/
Criptorquidismo
/
Infertilidad Masculina
Tipo de estudio:
Etiology_studies
/
Risk_factors_studies
Límite:
Child
/
Child, preschool
/
Humans
/
Infant
/
Male
Idioma:
En
Revista:
Int. braz. j. urol
Asunto de la revista:
UROLOGIA
Año:
2008
Tipo del documento:
Article
País de afiliación:
Suiza
Pais de publicación:
Brasil