Department of Urology, Anhui Provincial Children's Hospital and Children's Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.
Hormones (Athens). 2021 Mar;20(1):119-129. doi: 10.1007/s42000-020-00244-4. Epub 2020 Oct 29.
To systematically evaluate the effect of adjunctive hormonal therapy on testicular descent and spermatogenic function among children with cryptorchidism.
A comprehensive literature search of electronic databases up to February 21, 2019 was performed. Continuous data of fertility indices were evaluated using weighted mean difference (WMD) with 95% confidence interval (CI), while nominal data of fertility indices and the complete descent rates were analyzed by risk ratio (RR) with 95% CI. A fixed effect or random effect model was used.
A total of 27 previous studies were included for the current analysis. Hormonal therapy increased complete testicular descent rate, reaching statistical significance (RR = 3.74; 95% CI, 2.78-5.04; P < 0.001). The success rate was 22.43%. A similar result was found in subgroup analysis of hormonal category and effect on unilateral or bilateral cryptorchidism. Studies reporting primary outcome as continuous data showed that cryptorchid males have significantly increased germ cell numbers per tubule (WMD = 0.10; 95% CI, 0.01-0.20, P = 0.032) after hormonal therapy. The nominal data of pooled studies showed no significant difference (RR = 1.62; 95% CI, 0.65-4.00, P = 0.298). In addition, a significant result was noted in the luteinizing hormone-releasing hormone (LHRH) therapy group but not in those undergoing human chorionic gonadotropin (hCG) treatment.
Our findings have demonstrated that hormonal therapy can effectively increase the success rate of complete testicular descent, while some boys may benefit as regards improvement of the fertility index.
系统评价辅助激素治疗对隐睾儿童睾丸下降和生精功能的影响。
对截至 2019 年 2 月 21 日的电子数据库进行全面文献检索。使用加权均数差（WMD）和 95%置信区间（CI）评估生育指数的连续数据，而使用风险比（RR）和 95%CI 分析生育指数和完全下降率的名义数据。使用固定效应或随机效应模型。
共有 27 项先前的研究被纳入本次分析。激素治疗可显著提高完全睾丸下降率（RR=3.74；95%CI，2.78-5.04；P<0.001），成功率为 22.43%。在激素种类和对单侧或双侧隐睾影响的亚组分析中也得到了类似的结果。报告主要结局为连续数据的研究显示，隐睾男性在激素治疗后每个小管的生殖细胞数量显著增加（WMD=0.10；95%CI，0.01-0.20，P=0.032）。汇总研究的名义数据显示无显著差异（RR=1.62；95%CI，0.65-4.00，P=0.298）。此外，在促黄体生成素释放激素（LHRH）治疗组中观察到显著结果，但在人绒毛膜促性腺激素（hCG）治疗组中未观察到显著结果。
我们的研究结果表明，激素治疗可有效提高完全睾丸下降的成功率，而一些男孩的生育指数可能会得到改善。
