Undescended testis histology correlation with adult hormone levels and semen analysis

Cryptorchidism has been associated with infertility. We hypothesize that a positive correlation exists between testicular histopathology at orchiopexy and future fertility potential in patients with cryptorchidism.

Patients with cryptorchidism who underwent orchiopexy with bilateral testis biopsies were followed into adulthood. Testis histology was stratified into groups based on total germ cells per tubule and adult dark spermatogonia per tubule. After age 18 years, patients underwent hormonal testing and semen analysis. Mean semen analysis parameters and hormone levels were compared among histopathology groups.

A total of 91 patients with unilateral undescended testes and 19 with bilateral undescended testes had data for review. No significant differences in semen analysis parameters were seen among the germ cells per tubule groups. In unilateral undescended testis, sperm density and sperm count in the abnormal adult dark spermatogonia per tubule group remained within normal range but were significantly decreased (p = 0.005 and p = 0.028). Follicle-stimulating hormone levels were significantly higher in patients with unilateral undescended testis with abnormal adult dark spermatogonia per tubule but remained within normal range (p = 0.009). Sperm density was below normal range and was significantly decreased in the abnormal adult dark spermatogonia per tubule group in the bilateral undescended testes cohort (p = 0.0496). In bilateral undescended testes follicle-stimulating hormone level, sperm count and percent motility in the abnormal adult dark spermatogonia per tubule group were outside normal clinical range but these results were not statistically significant (p = 0.07-0.2).

Total germ cell histopathology at the time of orchiopexy was not associated with significant changes in hormone levels or semen analysis results in adulthood. Testis biopsy at orchiopexy may be limited in predicting future fertility in unilateral undescended testis but more clinically useful in predicting fertility potential for those with bilateral undescended testes.