| Neoadjuvant gonadotropin-releasing hormone therapy before surgery may improve the fertility index in undescended testes: a prospective randomized trial. | |
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MedLine Citation:
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PMID: 15711353 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Subfertility is considered the principal consequence of cryptorchidism even after timely orchiopexy. Gonadotropin-releasing hormone (GNRH) treatment appears to improve fertility later in life by inducing germ cell maturation. In a prospectively randomized trial we investigated whether preoperative GNRH therapy improves the fertility index in primary cryptorchidism. MATERIALS AND METHODS: A total of 42 boys 11 to 100 months old (median 33.5) with 63 undescended testes were prospectively assigned to 2 groups during a 6-month period. Patients were randomized to receive either orchiopexy alone (21 patients) or with neoadjuvant GNRH therapy (21) as a nasal spray for 4 weeks at 1.2 mg per day. In both groups testicular biopsies were performed at the time of orchiopexy and histopathological fertility index was determined. RESULTS: Mean fertility index in the group treated with GNRH before surgery was significantly higher (1.05, SD +/- 0.71) compared to the group without hormonal stimulation (0.52, SD +/- 0.39, p <0.05). The subgroup of neoadjuvant stimulated boys younger than 24 months achieved the best results compared to the age matched boys without hormonal treatment. CONCLUSIONS: Neoadjuvant GNRH treatment improves fertility index in prepubertal cryptorchidism. Consequently, preoperative hormone therapy should improve fertility in adulthood. Additionally, the nasal application is well tolerated, safe and already recommended in an adjuvant setting after orchiopexy. Maximum salvage of active germinal tissue is achieved by treating cryptorchidism before the end of the first year of life. |
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Authors:
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Christian Schwentner; Josef Oswald; Alfons Kreczy; Andreas Lunacek; Georg Bartsch; Martina Deibl; Christian Radmayr |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: The Journal of urology Volume: 173 ISSN: 0022-5347 ISO Abbreviation: J. Urol. Publication Date: 2005 Mar |
Date Detail:
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Created Date: 2005-02-15 Completed Date: 2005-03-29 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0376374 Medline TA: J Urol Country: United States |
Other Details:
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Languages: eng Pagination: 974-7 Citation Subset: AIM; IM |
Affiliation:
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Department of Pediatric Urology, Medical University Innsbruck, Innsbruck, Austria. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Chemotherapy, Adjuvant Child Child, Preschool Cryptorchidism / complications, drug therapy*, surgery Gonadotropin-Releasing Hormone / therapeutic use* Humans Infant Infertility, Male / etiology, prevention & control* Male Preoperative Care Prospective Studies Spermatogonia* |
| Chemical | |
Reg. No./Substance:
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33515-09-2/Gonadotropin-Releasing Hormone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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