Efficacy and safety of human chorionic gonadotropin for treatment of cryptorchidism: A meta‐analysis of randomised controlled trials

Yi, Wei; Wang, Yangcai; Tang, Xiangliang; Liu, Bin; Shen, L.; Chen, Long; Lin, Tao; He, Dalin; Wu, Shengde; Wei, Guanghui

doi:10.1111/jpc.13920

Cited by 20 publications

(10 citation statements)

References 20 publications

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“…This was probably due to an anatomical alteration linked to the syndrome itself, such as a short spermatic cord. In any case, these results are broadly in line with the other literature reports on hCG therapy and cryptorchidism [42].…”

Section: Discussionsupporting

confidence: 92%

Adverse pathophysiological influence of early testosterone therapy on the testes of boys with higher grade sex chromosome aneuploidies (HGAs): a retrospective, cross-sectional study

Spaziani

Tarantino

Pozza

et al. 2020

J Endocrinol Invest

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Purpose Higher grade aneuploidies (HGAs) of the male sex chromosomes are a rare genetic group of pathologies caused by nondisjunction meiotic events. The aim of this study was to evaluate the impact of early androgenic therapy on the testicular secretory hormone profile, and the pathophysiological implications. Patients and methods In this cross-sectional study, 18 HGA subjects aged 6–8 years were recruited. They were divided into two groups, based on whether or not they had previously undergone testosterone therapy (group 1: 11 untreated subjects; group 2: 7 treated subjects). Serum FSH, LH, testosterone (T), inhibin B (INHB) and anti-Müllerian hormone (AMH) were determined, and auxological parameters were assessed. Five group 1 patients and four group 2 patients were treated with hCG (human chorionic gonadotropin) for inguinal cryptorchidism; their hormone profile and auxological parameters were assessed both pre- and post-hCG treatment. Results Group 1 subjects showed significantly higher testicular volume and higher levels of AMH and INHB (p < 0.0001). Subjects who had undergone hCG therapy showed a significantly higher testicular volume, penis length (respectively, p = 0.008 and p = 0.0005 for group 1 and p = 0.04 and p = 0.001 for group 2) and T (p = 0.005 for group 1 and p = 0.004 for group 2). Conclusions HGA patients undergoing early testosterone therapy show an earlier and persistent suppression of testicular secretory function. At this age, the testes are still responsive to stimulation with hCG. The selection of patients to be treated must be accompanied by a thorough clinical and hormonal evaluation.

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Section: Discussionsupporting

confidence: 92%

Adverse pathophysiological influence of early testosterone therapy on the testes of boys with higher grade sex chromosome aneuploidies (HGAs): a retrospective, cross-sectional study

Spaziani

Tarantino

Pozza

et al. 2020

J Endocrinol Invest

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“…Notably, the reported success rates of orchiopexy have been more than 70% in most studies (218,225). A more recent meta-analysis of hCG for cryptorchidism treatment in 2018 included seven randomized controlled trials, which assessed the efficacy of treatment with parenteral hCG as compared with intranasal GnRH or placebo (227). Different doses and regimens of hCG and GnRH were used.…”

Section: Role Of Hormonal Treatment In Cryptorchidismmentioning

confidence: 99%

“…Different doses and regimens of hCG and GnRH were used. hCG induced complete testicular descent in 0-50.8% of patients with unilateral cryptorchidism and 0-22.4% of patients with bilateral cryptorchidism (227). The Nordic consensus published in 2007, European Urology guideline in 2016, and the American Urology Association guideline in 2014 do not recommend hormonal treatment for inducing testicular descent in cryptorchid patients and recommend orchiopexy as the preferred method of treatment (16,218,219).…”

Section: Role Of Hormonal Treatment In Cryptorchidismmentioning

confidence: 99%

Hypogonadism and Cryptorchidism

et al. 2020

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Congenital cryptorchidism (undescended testis) is one of the most common congenital urogenital malformations in boys. Prevalence of cryptorchidism at birth among boys born with normal birth weight ranges from 1.8 to 8.4%. Cryptorchidism is associated with a risk of low semen quality and an increased risk of testicular germ cell tumors. Testicular hormones, androgens and insulin-like peptide 3 (INSL3), have an essential role in the process of testicular descent from intra-abdominal position into the scrotum in fetal life. This explains the increased prevalence of cryptorchidism among boys with diseases or syndromes associated with congenitally decreased secretion or action of androgens, such as patients with congenital hypogonadism and partial androgen insensitivity syndrome. There is evidence to support that cryptorchidism is associated with decreased testicular hormone production later in life. It has been shown that cryptorchidism impairs long-term Sertoli cell function, but may also affect Leydig cells. Germ cell loss taking place in the cryptorchid testis is proportional to the duration of the condition, and therefore early orchiopexy to bring the testis into the scrotum is the standard treatment. However, the evidence for benefits of early orchiopexy for testicular endocrine function is controversial. The hormonal treatments using human chorionic gonadotropin (hCG) or gonadotropin-releasing hormone (GnRH) to induce testicular descent have low success rates, and therefore they are not recommended by the current guidelines for management of cryptorchidism. However, more research is needed to assess the effects of hormonal treatments during infancy on future male reproductive health.

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“…Men born with cryptorchidism are twice as likely to have reduced fertility when compared to those born with their testes in the scrotum, even after orchidopexy [2,18,19]. The reduction of fertility in men operated on because of bilateral cryptorchidism is estimated at 38% (infertility and azoospermia) [20].…”

Section: Pathophysiologymentioning

confidence: 99%

Epidemiology, pathophysiology, and pathogenesis of cryptorchidism. Evaluation and treatment of undescended testicle

Toliczenko-Bernatowicz¹,

Matuszczak²,

Komarowska³

et al. 2020

polp

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Cryptorchidism-the absence of one or both testes in the normal scrotal position-is the most common birth defect of the male genitalia. In full-term newborn boys its incidence is estimated at 2-5%. During the first three months of life, in half of these boys the testicles will descend spontaneously into the scrotum, but at the end of the first year of life 1% of boys will have cryptorchidism. Among boys born prematurely, about 30% of them have undescended testicles at birth, but also in such cases approximately 80% of undescended testes descend by the third month of life. The authors discuss the epidemiology, pathophysiology, aetiology, and treatment of undescended testicle in boys.

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Efficacy and safety of human chorionic gonadotropin for treatment of cryptorchidism: A meta‐analysis of randomised controlled trials

Abstract: A meta-analysis of the seven studies led us to conclude that hCG treatment is no more effective than placebo, and there were no significant differences in the effectiveness of hCG versus GnRH treatment.

Cited by 20 publications

References 20 publications

Adverse pathophysiological influence of early testosterone therapy on the testes of boys with higher grade sex chromosome aneuploidies (HGAs): a retrospective, cross-sectional study

Adverse pathophysiological influence of early testosterone therapy on the testes of boys with higher grade sex chromosome aneuploidies (HGAs): a retrospective, cross-sectional study

Hypogonadism and Cryptorchidism

Epidemiology, pathophysiology, and pathogenesis of cryptorchidism. Evaluation and treatment of undescended testicle

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