Sex Dev. 2019;13(1):3-10. doi: 10.1159/000496418. Epub 2019 Jan 26.
Abnormal germ cell development in cryptorchidism is not a result of a congenital dysgenesis but is preceded by a hormone imbalance and perturbation in germ cell-specific gene expression during abrogated mini-puberty. Adequate treatment with low doses of GnRHa enables 86% of men to achieve a normal sperm count and, most importantly, prevent development of azoospermia. GnRHa treatment induces a significant transcriptional response, including protein coding genes involved in pituitary development, the hypothalamic-pituitary-gonadal axis, and testosterone synthesis. Furthermore, hormonal treatment to achieve epididymo-testicular descent as a first choice of treatment of cryptorchidism has a long tradition in Europe. It eliminates the necessity of subsequent surgery. Moreover, in the cases of non-responders it facilitates orchidopexy and contributes considerably to a reduced incidence of unilateral and the more serious bilateral complete post-surgical testicular atrophy.
隐睾症中异常的生殖细胞发育不是先天性发育不良的结果，而是在被阻断的小青春期期间激素失衡和生殖细胞特异性基因表达紊乱所导致的。用低剂量的 GnRHa 进行充分治疗，可使 86%的男性精子计数恢复正常，最重要的是，可防止无精子症的发生。GnRHa 治疗会引起显著的转录反应，包括涉及垂体发育、下丘脑-垂体-性腺轴和睾酮合成的蛋白质编码基因。此外，在欧洲，用激素治疗来实现附睾-睾丸下降作为隐睾症的首选治疗方法已有很长的历史。它消除了后续手术的必要性。此外，对于无反应者，它有利于睾丸固定术，并大大降低单侧和更严重的双侧完全手术后睾丸萎缩的发生率。
