Hadziselimovic Faruk, Hocht Burckhard, Herzog Bruno, Buser Mauro W
Kindertagesklinik Liestal, Liestal, Switzerland.
Horm Res. 2007;68(1):46-52. doi: 10.1159/000100874. Epub 2007 Mar 14.
Cryptorchidism represents the most common endocrine disease in boys, with infertility frequently observed in unilateral as well as bilateral forms. In this study, we examined the role of Ad (dark) spermatogonia for fertility in cryptorchid boys. The hypothesis to be proven was that boys lacking Ad spermatogonia will develop infertility despite a successful orchidopexy at an early age.
To estimate total sperm count, one of the most predictive parameters of male fertility, we analyzed the ejaculatein 218 cryptorchid men and correlated it with the developmental stage of their germ cells at the time of successful surgery.
Abnormal sperm concentration (<40 x 10(6)/ejaculate) was found in half of the patients under the study. 47.5% of unilateral and 78% of bilateral cryptorchid males had their sperm concentration in the infertility range according to the WHO standards. If transformation into Ad spermatogonia had occurred, age-related differences in the fertility outcome was observed. The younger the unilateral cryptorchid boys were at surgery, the higher their sperm count. Age-related difference was not found in the group of cryptorchid men having had no A dark spermatogonia at time of surgery, indicating that in this group a successful orchidopexy is insufficient to prevent infertility development and, in particular, the development of azoospermia.
The presence of Ad spermatogonia at surgery is an excellent prognostic parameter for future fertility. Cryptorchid boys lacking these cells will develop infertility despite successful orchidopexy at an early age.
隐睾症是男孩最常见的内分泌疾病，单侧和双侧隐睾症患者常出现不育。在本研究中，我们研究了Ad（暗）型精原细胞在隐睾症男孩生育中的作用。有待证实的假设是，缺乏Ad型精原细胞的男孩，即使在幼年时成功进行了睾丸固定术，仍会出现不育。
为了评估男性生育能力最具预测性的参数之一——总精子计数，我们分析了218例隐睾症男性的精液，并将其与成功手术时生殖细胞的发育阶段相关联。
研究中的患者有一半精子浓度异常（<40×10⁶/次射精）。根据世界卫生组织标准，47.5%的单侧隐睾症男性和78%的双侧隐睾症男性精子浓度处于不育范围。如果已发生向Ad型精原细胞的转化，则观察到生育结果存在年龄相关差异。单侧隐睾症男孩手术时年龄越小，精子计数越高。在手术时没有Ad暗型精原细胞的隐睾症男性组中未发现年龄相关差异，这表明在该组中，成功的睾丸固定术不足以预防不育的发生，尤其是无精子症的发生。
手术时存在Ad型精原细胞是未来生育的一个良好预后参数。缺乏这些细胞的隐睾症男孩，即使在幼年时成功进行了睾丸固定术，仍会出现不育。
