Fertility potential after unilateral and bilateral orchidopexy for cryptorchidism

Abstract

Men who underwent bilateral orchidopexy in their childhood have appreciably poorer prognosis for fertility compared to men who underwent a unilateral procedure. Our study also confirmed that men who underwent unilateral orchidopexy in their childhood before the age of 8 years have better prognosis for fertility compared to those who were operated later.

Age at Surgery and Outcomes of an Undescended Testis

“…This is of concern, as late orchidopexy may be associated with increased risk of testicular cancer and diminished fertility potential in boys. [22][23][24][25][26] Two recent systematic reviews reported a 2-to 32-fold increased risk of testicular cancer in men with a history of UDT, with the risk lower for younger age at orchidopexy but higher for previous bilateral UDT. 8,27 Such findings have prompted a significant reduction in the recommended age to perform orchidopexy in the past decades, to its current 12 months of age.…”

Antisperm Antibodies in Undescended Testis

“…Other studies of hormonal profiles have documented different levels of inhibin B, FSH and LH levels. Patients with bilateral undescended testes have significantly lower sperm concentration and inhibin B levels, while showing higher FSH and LH levels than those with unilateral undescended testis [23].…”

High Undescended Testis Treatment with Distal Espermatic Vessel Ligation (Koff-Sethi Technique)

“…This has been confirmed by studies showing improvement of both testicular volume and sperm count in children operated before two years of age [1]- [3]. Patients who underwent treatment for bilateral undescended testis have a reduced fertility potential when compared to patients with unilateral orchiopexy, as confirmed by Trsinar and Muravec [4]. Another clinical problem linked to cryptorchidism is the incidence of testicular tumors, considered to be 5 to 10 times higher than in the general population [5].…”