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Paternity after bilateral cryptorchidism. A controlled study
P A Lee1, L A O'Leary, N J Songer
1Department of Pediatrics, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh, Pa, USA. leep@chplink.chp.edu
Insights
Paternity is significantly reduced in men with a history of bilateral cryptorchidism compared to unilateral cases and controls. Infertility is substantially more common in the bilateral group.
Area of Science:
- Urology
- Reproductive Medicine
- Pediatric Surgery
Background:
- Cryptorchidism, the failure of one or both testes to descend, is a common congenital condition in males.
- Undescended testes are associated with an increased risk of infertility and testicular cancer.
- Surgical correction (orchiopexy) is typically performed in childhood to mitigate these risks.
Purpose of the Study:
- To compare paternity rates among men with a history of bilateral cryptorchidism versus unilateral cryptorchidism and a control group.
- To investigate the long-term reproductive outcomes in men treated for cryptorchidism.
Main Methods:
- An epidemiologic survey was conducted using questionnaires.
- Study cohort included men who underwent orchiopexy for bilateral or unilateral cryptorchidism between 1955 and 1971.
- A control group of men without a history of cryptorchidism was also surveyed.
Main Results:
- Paternity rates were 50% in the bilateral cryptorchidism group, compared to 76% in controls and 74% in the unilateral group.
- When considering men who attempted paternity, rates were 62% (bilateral), 94% (control), and 89% (unilateral).
- Infertility was 3.5 times more frequent in the bilateral group than the unilateral group, and over 6 times more frequent than in controls.
Conclusions:
- Bilateral cryptorchidism significantly compromises paternity compared to unilateral cryptorchidism and controls.
- The risk of infertility is substantially elevated following bilateral cryptorchidism.
- No correlation was found between the age of orchiopexy or lifestyle factors and paternity outcomes.
Objective:
To compare paternity among men with former bilateral cryptorchidism (referred to as the bilateral group) with a group of men with former unilateral cryptorchidism (referred to as the unilateral group) and a control group.
Design:
Epidemiologic survey of study cohort.
Setting:
Large urban pediatric hospital.
Subjects:
Men with former bilateral and unilateral cryptorchidism who underwent orchiopexy between 1955 and 1971 at the Children's Hospital of Pittsburgh, Pittsburgh, Pa, and a group of control men have been surveyed by questionnaire concerning paternity and factors related to paternity.
Main Outcome Measure:
Paternity.
Results:
Among the married men who had bilateral cryptorchidism, 50% had fathered children, compared with 76% in the control group and 74% in the unilateral group. Data were similar when the men who were cohabitating were included with the married men. When men who had married and had attempted paternity were evaluated, 62% of the men in the bilateral group had been able to father children compared with 94% of the control group and 89% of the men in the unilateral group. No relationship was noted between the age of orchiopexy or lifestyle factors and paternity. Paternity among all groups was related to female-related infertility factors and to the presence of varicoceles.
Conclusions:
Paternity was compromised after bilateral cryptorchidism when compared with men with former unilateral cryptorchidism and a control group. Among the bilateral group, infertility is about 3.5 times as frequent than the unilateral group and more than 6 times as frequent among the control group. No correlation was found between age of orchiopexy and paternity for either group.
