Possible testicular 3 beta-hydroxysteroid dehydrogenase deficiency in cryptorchid neonates.

In order to explain the impaired neonatal secretion of testosterone (T) in cryptorchid neonates, plasma levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), precursors of T, and T were measured in bilateral cryptorchid and control babies from the first to the 90th day of life. RIA of steroids was performed after plasma ether extraction and celite ethylen glycole column chromatography. In comparison to the neonatal period, plasma LH, dehydroepiandrosterone (DHA), and T were increased in both groups at the 60th day, although cryptorchids showed significantly lower T level (1018 +/- 168 pg/ml) than controls (1985 +/- 410 pg/ml, p less than 0.001). At the same time, androstenedione (A) and 17 alpha-hydroxy-progesterone (17P) remained unchanged. Dihydrotestosterone (DHT) concentrations were higher in cryptorchids in the neonatal period, and increased in both groups at the second to third month of life. The T/DHT ratio was significantly higher in cryptorchids in all age groups. These data indicate that (1) neonatal T formation probably occurs through the delta 5 pathway; (2) impaired T secretion in cryptorchid neonates could be due to a deficiency of 3 beta-hydroxysteroid dehydrogenase; and (3) cryptorchid neonates exhibit an elevated 5 alpha-reductase activity of unknown origin.