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Testicular Histology in Cryptorchid Boys – Aspects of Fertility (Abstract)

D. Cortes, B. Laub Petersen, J. Thorup
Copenhagen, Denmark 



Background: Cryptorchidism is associated with infertility. The aim of this study was to evaluate the progression of germ cell damage during childhood of cryptorchid boys.
Material and methods: The material included 963 cryptorchid patients <12 years at surgery with biopsy at surgery (1168 specimens) and testicular tissue from 35 human cryptorchid fetuses >28 weeks of gestation with intra-abdominal or intracanalicular tests (70 specimens). From the testicular biopsies the number of spermatogonia and gonocytes, if any/tubule was measured and compared to a normal material. 
Results: All cryptorchid fetuses exhibited germ cells. Germ cells disappeared from 18-months of age. Hereafter, the frequency of no germ cells at surgery increased with increasing age (p<0.00001). In 77% (27/35) of the cryptorchid fetuses a normal number of germ cells were found. The number of germ cells decreased dramatically within the first two years of life. After 2 years of life the frequency of a normal number of germ cells was about 9% only.
Conclusions: We recommend surgery for cryptorchidism before the germ cells disappear, i.e. before 15-months of age; especially in bilateral cryptorchidism. We recommend a testicular biopsy simultaneously with surgery for cryptorchidism. The histological findings may be helpful when deciding whether a cryptorchid boy older than 15 months may be offered supplementary hormonal treatment in order to stimulate germ cell proliferation after surgery. 
Key words: cryptorchidism, testis, infertility, germ cells.


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