Reproductive hormone levels in infants with cryptorchidism during postnatal activation of the pituitary-testicular axis

Purpose: Testosterone and luteinizing hormone secretion is reportedly impaired in infants born with cryptorchidism. To better characterize this phenomenon, we studied a range of hormones that normally increase in boys during the first few months of life. Materials and Methods: A case-control study was conducted of boys with nonsyndromic cryptorchidism identified at birth (cases) and boys with descended testes presenting to the urology clinic without endocrine related concerns (controls). Blood was obtained at approximately 2 months of age and up to 3 urine samples were obtained at monthly intervals until age 120 days. Testosterone, estradiol, luteinizing hormone and follicle-stimulating hormone were measured in plasma and urine, and inhibin B, sex hormone-binding globulin (SHBG) and leptin were measured in plasma using standard assays. Data were analyzed using t tests with and without log transformation. Results: Of 20 cases 15 were unilaterally cryptorchid. Although 7 testes descended spontaneously, 2 became cryptorchid again during followup and, therefore, 15 boys required orchiopexy. Diagnoses of 26 controls included foreskin problems (15), prenatal hydronephrosis (4), penile torsion (2), ectopic kidney (1) and hydrocele (1). None of the plasma or urinary hormone measurements was significantly different between boys requiring orchiopexy and controls. Plasma SHBG and testosterone, SHBG, estradiol and leptin, and body mass index positively correlated, while testosterone and body mass index negatively correlated. Conclusions: We failed to identify any significant differences in hormone levels between controls and boys with cryptorchidism during activation of the pituitary-testicular axis in early infancy. These data suggest that impairment of this process may be uncommon in boys with nonsyndromic cryptorchidism.