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Updated: Jun 23, 2026
Fertility Preservation Through Oocyte Vitrification: Clinical and Laboratory Perspectives
Published on: September 16, 2021
Neoadjuvant gonadotropin-releasing hormone therapy before surgery and effect on fertility index in unilateral
Mohamed Jallouli1, Tarek Rebai, Nouha Abid
1Department of Pediatric Surgery, Hedi Chaker Hospital, Sfax, Tunisia. mohamed.jallouli@rns.tn
Objectives:
To investigate, in a prospectively randomized trial, whether preoperative gonadotropin-releasing hormone (GnRH) therapy improves the fertility index in primary cryptorchidism. Cryptorchidism is a common condition with a high risk of infertility. Treatment with GnRH appears to improve fertility later in life by inducing germ cell maturation.
Methods:
A total of 24 boys, 12-123 months old (median 34.5), with 24 undescended testes were prospectively assigned to 2 groups during a 24-month period. The patients were randomized to receive either orchiopexy alone (n = 12) or orchiopexy combined with neoadjuvant GnRH therapy (n = 12) as a nasal spray for 4 weeks at 1.2 mg/d. In both groups, testicular biopsies were performed at orchiopexy, and the histopathologic fertility index was determined.
Results:
The mean fertility index in the group treated with GnRH before surgery was significantly greater (0.88 +/- 0.31) than in the group without hormonal stimulation (0.49 +/- 0.52; P = .02). No significant correlation was found between the fertility index in the GnRH group and the patient's age.
Conclusions:
The results of our study have shown that neoadjuvant GnRH treatment improves the fertility index in prepubertal cryptorchidism and, consequently, should improve fertility in adulthood.
