Fertility potential after unilateral and bilateral orchidopexy for cryptorchidism.

OBJECTIVES

The aim of the study was to compare fertility potential in patients who had been operated upon in childhood because of unilateral or bilateral cryptorchidism.

METHODS

The study covered 68 men (age 25-30 years) with a history of unilateral (49) or bilateral orchidopexy (Mandat et al. in Eur J Pediatr Surg 4:94-97, 1994). Fertility potential was estimated with semen analysis (sperm concentration, motility and morphology), testicular volume measurement and hormonal status evaluation [follicle-stimulating hormone (FSH) and inhibin B levels]. Differences were analysed with the nonparametric Mann-Whitney test.

RESULTS

The group of subjects with bilateral orchidopexy had significantly decreased sperm concentration (P = 0.047), sperm motility (P = 0.003), inhibin B level (P = 0.036) and testicular volume (P = 0.040), compared to subjects with unilateral orchidopexy. In the group with bilateral orchidopexy, there was a strong negative correlation between inhibin B and FSH levels (P < 0.001, r (s) = -0.772). Sperm concentration in this group correlated positively with inhibin B level (P = 0.004, r (s) = 0.627) and negatively with FSH level (P = 0.04, r (s) = -0.435). The group of subjects with unilateral orchidopexy who had been operated before the age of 8 years had significantly increased inhibin B level (P = 0.006) and testicular volume (P = 0.007) and decreased FSH level (P = 0.01), compared to subjects who had been operated at the age of 8 or later.

CONCLUSIONS

Men who underwent bilateral orchidopexy in their childhood have appreciably poorer prognosis for fertility compared to men who underwent a unilateral procedure. Our study also confirmed that men who underwent unilateral orchidopexy in their childhood before the age of 8 years have better prognosis for fertility compared to those who were operated later.