Abstract：
OBJECTIVE: An impaired germ cell number per tubular cross-section (G/T) at orchidopexy indicates a high risk of infertility. A recent study in boys with bilateral cryptorchidism showed a very high predictive value for a low serum inhibin-B level, indicating bilateral impaired G/T. Several other studies have shown a fairly strong correlation between inhibin-B and G/T. We aimed to evaluate if inhibin-B levels at orchidopexy improved at follow-up in boys with unilateral cryptorchidism.
METHODS: We included 280 boys with unilateral non-syndromic cryptorchidism at the median age of 1 year (4 months-9 years) who underwent orchidopexy. They were evaluated for serum FSH, LH and inhibin-B levels at surgery and at follow-up (median 16 months later), including multiple of the median (MoM) estimations of inhibin-B due to the age dependency of normal levels.
RESULTS: The inhibin-B MoM score improved significantly at follow-up. At orchidopexy, 59 (21%) boys had inhibin-B levels below the normal 2.5-percentile indicating impaired G/T bilaterally. At follow-up, 36% of the boys still had low inhibin-B. At orchidopexy, 221 (79%) boys had inhibin-B levels above normal 2.5-percentile and only 5% had low inhibin-B levels at follow-up. The risk of low inhibin-B levels at follow-up was significantly different between the two groups (p < 0.0001). At follow-up, totally, 32 (11%) boys had low inhibin-B levels, hereof only 3 patients with increased FSH.
CONCLUSIONS: Orchidopexy benefits the fertility potential. About 10% of boys with unilateral non-syndromic cryptorchidism may have a bilateral testicular disease reducing their fertility potential. Insufficient gonadotropin stimulation may possibly be the cause.
METHODS: We included 280 boys with unilateral non-syndromic cryptorchidism at the median age of 1 year (4 months-9 years) who underwent orchidopexy. They were evaluated for serum FSH, LH and inhibin-B levels at surgery and at follow-up (median 16 months later), including multiple of the median (MoM) estimations of inhibin-B due to the age dependency of normal levels.
RESULTS: The inhibin-B MoM score improved significantly at follow-up. At orchidopexy, 59 (21%) boys had inhibin-B levels below the normal 2.5-percentile indicating impaired G/T bilaterally. At follow-up, 36% of the boys still had low inhibin-B. At orchidopexy, 221 (79%) boys had inhibin-B levels above normal 2.5-percentile and only 5% had low inhibin-B levels at follow-up. The risk of low inhibin-B levels at follow-up was significantly different between the two groups (p < 0.0001). At follow-up, totally, 32 (11%) boys had low inhibin-B levels, hereof only 3 patients with increased FSH.
CONCLUSIONS: Orchidopexy benefits the fertility potential. About 10% of boys with unilateral non-syndromic cryptorchidism may have a bilateral testicular disease reducing their fertility potential. Insufficient gonadotropin stimulation may possibly be the cause.
摘要：
目的：睾丸固定术时每个肾小管横截面（G/T）的生殖细胞数量受损表明不育的风险很高。最近一项针对双侧隐睾男孩的研究显示，低血清抑制素B水平具有很高的预测价值。指示双侧受损G/T。其他几项研究表明，抑制素B和G/T之间有相当强的相关性。我们旨在评估单侧隐睾男孩的睾丸固定术中抑制素B水平是否在随访中得到改善。
方法：我们纳入了280名患有单侧非综合征隐睾的男孩，中位年龄为1岁（4个月-9岁），接受了睾丸固定术。对他们进行了血清FSH评估，手术和随访时的LH和抑制素-B水平（中位16个月后），由于正常水平的年龄依赖性，包括抑制素B的中位数（MoM）估计值的倍数。
结果：随访时抑制素-BMoM评分明显改善。在Orchidopexy，59名（21％）男孩的抑制素B水平低于正常的2.5百分位数，表明双侧G/T受损。在后续行动中,36％的男孩仍然具有低抑制素B。在Orchidopexy，221（79％）男孩的抑制素B水平高于正常的2.5百分位数，只有5％的男孩在随访时抑制素B水平较低。两组随访时抑制素-B水平低的风险有显著差异(p<0.0001)。在后续行动中,完全,32名（11%）男孩的抑制素-B水平较低，仅3例FSH升高。
结论：Orchidopexy有利于生育潜力。约有10％的单侧非综合征性隐睾男孩可能患有双侧睾丸疾病，从而降低了其生育能力。促性腺激素刺激不足可能是原因。
方法：我们纳入了280名患有单侧非综合征隐睾的男孩，中位年龄为1岁（4个月-9岁），接受了睾丸固定术。对他们进行了血清FSH评估，手术和随访时的LH和抑制素-B水平（中位16个月后），由于正常水平的年龄依赖性，包括抑制素B的中位数（MoM）估计值的倍数。
结果：随访时抑制素-BMoM评分明显改善。在Orchidopexy，59名（21％）男孩的抑制素B水平低于正常的2.5百分位数，表明双侧G/T受损。在后续行动中,36％的男孩仍然具有低抑制素B。在Orchidopexy，221（79％）男孩的抑制素B水平高于正常的2.5百分位数，只有5％的男孩在随访时抑制素B水平较低。两组随访时抑制素-B水平低的风险有显著差异(p<0.0001)。在后续行动中,完全,32名（11%）男孩的抑制素-B水平较低，仅3例FSH升高。
结论：Orchidopexy有利于生育潜力。约有10％的单侧非综合征性隐睾男孩可能患有双侧睾丸疾病，从而降低了其生育能力。促性腺激素刺激不足可能是原因。
