Mieusset R, Bujan L, Massat G, Mansat A, Pontonnier F
Centre de Stérilité Masculine, Hôpital La Grave, Toulouse, France.
Hum Reprod. 1995 Mar;10(3):613-9. doi: 10.1093/oxfordjournals.humrep.a135998.
Out of 85 fertile and 1014 infertile men, two (2.4%) and 95 (9.4%) respectively had a history of cryptorchidism. Thus cryptorchidism appears to be a risk factor for fertility since this difference was significant. Further comparisons showed that the volume of a former cryptorchid testis was smaller than the contralateral normally descended one and that sperm output/concentration was more impaired in bilateral than in unilateral cryptorchidism. A retractile testis, defined as a testis reported by the patient to be spontaneously and regularly, i.e. at least once a week, ascending up into a supra-scrotal position, was more frequent in infertile men with a history of cryptorchidism than in fertile men. Retractility was more frequent on the cryptorchid side, and was found more frequently after hormonal than after surgical treatment. Independently of all epidemiological and clinical parameters studied, retractility was associated with a lower sperm output. Among the infertile men with a history of cryptorchidism, 45% had an abnormally high scrotal temperature. This abnormal temperature represented a pejorative risk factor for fertility in this group, since it was associated with a more severely impaired spermatogenesis and a higher incidence of primary infertility than in infertile men with a history of cryptorchidism but normal scrotal temperatures.
在85名生育能力正常的男性和1014名不育男性中,分别有2名(2.4%)和95名(9.4%)有隐睾病史。由于这种差异具有统计学意义,因此隐睾似乎是生育能力的一个风险因素。进一步比较显示,既往有隐睾病史的睾丸体积小于对侧正常下降的睾丸,并且双侧隐睾比单侧隐睾的精子输出/浓度受损更严重。可回缩睾丸定义为患者报告睾丸自发且规律地(即至少每周一次)升入阴囊上方位置,在有隐睾病史的不育男性中比在生育能力正常的男性中更常见。可回缩性在隐睾侧更常见,并且在激素治疗后比手术治疗后更常见。独立于所有研究的流行病学和临床参数,可回缩性与较低的精子输出相关。在有隐睾病史的不育男性中,45%的人阴囊温度异常升高。这种异常温度是该组生育能力的一个不良风险因素,因为与阴囊温度正常的有隐睾病史的不育男性相比,它与更严重受损的精子发生和更高的原发性不育发生率相关。