Gonadotropins for testicular descent in cryptorchid congenital hypogonadotropic hypogonadism males beyond infancy
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Shreya Sharma
Abstract
Objectives
To study the effect of combined gonadotropin therapy (CGT) on testicular descent ± spermatogenesis in congenital hypogonadotropic hypogonadism (CHH) patients with cryptorchidism beyond infancy.
Methods
This retrospective cohort study included CHH patients with cryptorchidism [bilateral (n=5) or unilateral (n=1)] treated with CGT for testicular descent ± pubertal induction. All participants were treated with CGT [human menopausal gonadotropin (hMG) and human chorionic gonadotropin (hCG)] with hMG pretreatment in three and monitored for changes in testicular volume (TV), serum total testosterone (T), serum inhibin-B, and sperm concentration.
Results
Complete testicular descent to the scrotal position was achieved in 5/6 patients (10/11 testes) after 4.7 ± 1.6 months of treatment. There was 44 ± 18%, 97.5% (IQR: 44–195), 10-fold (IQR: 3–19.6), and two-fold (IQR: 1.7–9.3) increase in stretched penile length, ultrasound measured TV, T level, and serum inhibin-B from baseline, respectively. In two pediatric cases, testicular descent occurred with isolated hMG therapy. At the last follow up (median: 23.5, IQR: 10.5–38.7 months), all the descended testes remained in scrotal position. In four pubertal/postpubertal age patients, continuous CGT (18–60 months) yielded T and inhibin-B levels of 16.64 ± 1.46 nmol/l and 106 ± 32.6 pg/mL, respectively. All the three patients with available semen analysis had sperm concentration of ≥5 million/mL and one of them achieved paternity.
Conclusions
A trial of CGT before orchiopexy may be considered in CHH males with cryptorchidism even beyond the narrow age-window of infancy. CGT may also have beneficial effects on future spermatogenesis and fertility outcomes in these patients.
Acknowledgments
We would like to acknowledge the role of Sneha Arya for her contribution in editing the genetics methodology in the manuscript.
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Research funding: None declared.
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Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
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Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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Informed consent: Written informed consent was waived off because of the retrospective nature of the study.
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Ethical approval: Approval from the institutional review board (Institutional Ethical committee III, Seth G S Medical College and KEM Hospital, Mumbai) was taken.
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Data Availability Statement: The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
References
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© 2021 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review Article
- Delivery factors and neonatal thyroid hormone levels: a systematic review
- Original Articles
- Birth prevalence of tetrahydrobiopterin deficiency in China: data from the national newborn screening program, 2013–2019
- Analysis of the CAG tract length in the Androgen Receptor gene in Mexican patients with nonsyndromic cryptorchidism
- Pituitary hypoplasia is the best MRI predictor of the severity and type of growth hormone deficiency in children with congenital growth hormone deficiency
- Urinary gonadotropin measurements by enhanced luminometric assays (LIA) for the evaluation of pubertal development
- Challenges in management of transient hyperinsulinism – a retrospective analysis of 36 severely affected children
- Who should return for an oral glucose tolerance test? A proposed clinical pathway based on retrospective analysis of 332 children
- Investigation of the prevalence of cardiovascular risk factors in obese patients diagnosed with metabolic syndrome in childhood and examination of left ventricular function by echocardiography
- Effect of l-carnitine supplementation on children and adolescents with nonalcoholic fatty liver disease (NAFLD): a randomized, triple-blind, placebo-controlled clinical trial
- Management of patients with X-linked hypophosphatemic rickets during Covid-19 pandemic lockdown
- Evaluation of the pathophysiological role of Fetuin A levels in adolescents with polycystic ovary syndrome
- Gonadotropins for testicular descent in cryptorchid congenital hypogonadotropic hypogonadism males beyond infancy
- Clinical characteristics and outcome of hospitalized children and adolescent patients with type 1 diabetes during the COVID-19 pandemic: data from a single center surveillance study in Egypt
- Letter to the Editor
- Revisiting the effect of GnRH analogue treatment on bone mineral density in young adolescents with gender dysphoria
- Case Reports
- Pulmonary and cutaneous mucormycosis in two children with diabetes mellitus type 1
- Pyruvate carboxylase deficiency type C as a differential diagnosis of diabetic ketoacidosis
- Barth syndrome with severe dilated cardiomyopathy and growth hormone resistance: a case report
- The utility of reverse phenotyping: a case of lysinuric protein intolerance presented with childhood osteoporosis
Articles in the same Issue
- Frontmatter
- Review Article
- Delivery factors and neonatal thyroid hormone levels: a systematic review
- Original Articles
- Birth prevalence of tetrahydrobiopterin deficiency in China: data from the national newborn screening program, 2013–2019
- Analysis of the CAG tract length in the Androgen Receptor gene in Mexican patients with nonsyndromic cryptorchidism
- Pituitary hypoplasia is the best MRI predictor of the severity and type of growth hormone deficiency in children with congenital growth hormone deficiency
- Urinary gonadotropin measurements by enhanced luminometric assays (LIA) for the evaluation of pubertal development
- Challenges in management of transient hyperinsulinism – a retrospective analysis of 36 severely affected children
- Who should return for an oral glucose tolerance test? A proposed clinical pathway based on retrospective analysis of 332 children
- Investigation of the prevalence of cardiovascular risk factors in obese patients diagnosed with metabolic syndrome in childhood and examination of left ventricular function by echocardiography
- Effect of l-carnitine supplementation on children and adolescents with nonalcoholic fatty liver disease (NAFLD): a randomized, triple-blind, placebo-controlled clinical trial
- Management of patients with X-linked hypophosphatemic rickets during Covid-19 pandemic lockdown
- Evaluation of the pathophysiological role of Fetuin A levels in adolescents with polycystic ovary syndrome
- Gonadotropins for testicular descent in cryptorchid congenital hypogonadotropic hypogonadism males beyond infancy
- Clinical characteristics and outcome of hospitalized children and adolescent patients with type 1 diabetes during the COVID-19 pandemic: data from a single center surveillance study in Egypt
- Letter to the Editor
- Revisiting the effect of GnRH analogue treatment on bone mineral density in young adolescents with gender dysphoria
- Case Reports
- Pulmonary and cutaneous mucormycosis in two children with diabetes mellitus type 1
- Pyruvate carboxylase deficiency type C as a differential diagnosis of diabetic ketoacidosis
- Barth syndrome with severe dilated cardiomyopathy and growth hormone resistance: a case report
- The utility of reverse phenotyping: a case of lysinuric protein intolerance presented with childhood osteoporosis
