[Cryptorchism and sterility]

The authors report their observations on the association of sterility with antecedent cryptorchidism. In 1 190 sterile men, 88 had history of cryptorchidism (bilateral in 55 cases and unilateral in 33 cases). All had testicles in normal position in the scrotum at the time of their clinical examination, whether or not they had had an operation. Of 73 cases operated, 46 had been followed, and amongst these, 12 had had an operation for varicocele. The majority of these patients had had treatment with clomiphene or androgens. In these patients the earlier the operation had been done, the better the chances for testicles of normal volume. Of 20 patients with azoospermia, 16 had had bilateral cryptorchidism. Only 9 of the whole group had a normal sperm analysis, while all the other had oligospermia, teratospermia and altered motility. One third the subjects had elevation of FSH and hypotestosteronemia, and in 13 with hypotestosteronemia, 10 had had bilateral cryptorchidism. Treatment resulted in 10 pregnancies. Since the majority of the patients had been treated late for their cryptorchidism, the authors advise bringing the testicles down before the age of 4. Hormonal treatment and varicocele ligature can improve fertility in sterile men having cryptorchidism in their past.