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Departments of Physiology and Pediatrics, University of Turku (A.-M.S., M.K., H.E.V., J.T.), FIN-20520 Turku, Finland; and University Department of Growth and Reproduction, GR-5064 Rigshospitalet (A.-M.S., K.M.M., I.M.S., M.C., K.A.B., I.N.D., C.M.K., N.E.S.), DK-2100 Copenhagen, Denmark
Address all correspondence and requests for reprints to: Dr. Jorma Toppari, Departments of Physiology and Pediatrics, University of Turku, Kiinamyllynkatu 10, FIN-20520 Turku, Finland. E-mail: jorma.toppari{at}utu.fi.
Context: Hormonal dysregulation has been suggested to be one of many etiological factors of cryptorchidism.
Objectives: The objective of this study was to assess the hypothalamic-pituitary-testicular axis in cryptorchid boys during the postnatal hormonal surge.
Design: This was a prospective, longitudinal, population-based study.
Setting: The study was performed at two primary obstetric centers.
Participants: Study participants included 388 Finnish and 433 Danish boys (88 and 34 with cryptorchidism, respectively).
Interventions: Clinical examinations were performed at 0 and 3 months. Blood samples were taken at 3 months.
Main Outcome Measures: The main outcome measures were testis position and reproductive hormone levels.
Results: Finnish cryptorchid boys had significantly higher FSH [1.59 (0.50–3.53) vs. 1.30 (0.49–2.92) IU/liter; P < 0.0001] and lower inhibin B [426 (254–770) vs. 459 (266–742) pg/ml; P < 0.015] levels than Finnish control boys [median (2.5th–97.5th percentiles)]. Danish cryptorchid boys had higher FSH levels than controls [1.47 (0.54–3.89) vs. 1.18 (0.41–3.04) IU/liter; P = 0.018]. Inhibin B levels in healthy Danish boys were lower than those in Finnish boys [380 (233–637) pg/ml; P < 0.0001] and were not reduced in Danish crypt-orchid boys [392 (236–672) pg/ml; P = 0.851]. Changes in hormone levels were strongest in boys with severe, persistent cryptorchidism, but were also detectable in mild and transient cryptorchidism. Effects on Leydig cell function were subtle, with an increase in LH in Finnish (but not Danish) cryptorchid boys vs. controls [1.97 (0.77–5.91) vs. 1.75 (0.58–4.04) IU/liter; P < 0.021], but testosterone levels remained within the normal range.
Conclusions: Our results support the hypothesis that cryptorchidism is associated with a primary testicular disorder, which could be a cause or a consequence of cryptorchidism. This malfunction is reflected by low inhibin B production in the Finnish cohort and high gonadotropin drive in both the Finnish and Danish cohorts.
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  H.E. Virtanen and J. Toppari Epidemiology and pathogenesis of cryptorchidism Hum. Reprod. Update, January 1, 2008; 14(1): 49 - 58. [Abstract] [Full Text] [PDF]
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 K. Bay, H. E. Virtanen, S. Hartung, R. Ivell, K. M. Main, N. E. Skakkebaek, A.-M. Andersson, The Nordic Cryptorchidism Study Group, and J. Toppari Insulin-Like Factor 3 Levels in Cord Blood and Serum from Children: Effects of Age, Postnatal Hypothalamic-Pituitary-Gonadal Axis Activation, and Cryptorchidism J. Clin. Endocrinol. Metab., October 1, 2007; 92(10): 4020 - 4027. [Abstract] [Full Text] [PDF]
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 K. M Main, J. Toppari, and N. E Skakkebaek Gonadal development and reproductive hormones in infant boys Eur. J. Endocrinol., November 1, 2006; 155(suppl_1): S51 - S57. [Abstract] [Full Text] [PDF]
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R. M. Sharpe Perinatal Determinants of Adult Testis Size and Function. J. Clin. Endocrinol. Metab., July 1, 2006; 91(7): 2503 - 2505. [Full Text] [PDF]
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