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JU Insight: Low Serum Inhibin B/Follicle-Stimulating Hormones and Anti-Mullerian Hormone/Follicle-Stimulating Hormones Ratios as Markers of Decreased Germ Cells in Infants with Bilateral Cryptorchidism
By: Taiki Kato, MD; Kentaro Mizuno, MD; Daisuke Matsumoto, MD; Hidenori Nishio, MD; Akihiro Nakane, MD; Satoshi Kurokawa, MD; Hideyuki Kamisawa, MD; Tetsuji Maruyama, MD; Shoichiro Iwatsuki, MD; Yukihiro Umemoto, MD; Takahiro Yasui, MD; Yutaro Hayashi, MD | Posted on: 01 Mar 2022
Kato T, Mizuno K, Matsumoto D et al: Low serum inhibin B/follicle-stimulating hormones and anti-Müllerian hormone/follicle-stimulating hormones ratios as markers of decreased germ cells in infants with bilateral cryptorchidism. J Urol 2021; 207: 227. https://doi.org/10.1097/JU.0000000000002344.
Study Need and Importance: Cryptorchidism is a major risk factor for infertility and germ cell development failure presents from infancy. Testicular histology, the mean number of germ cells per tubular transverse section (G/T), through a biopsy during orchidopexy is the most frequently used method to predict future infertility. However, clinical markers that identify potential infertility, avoiding the need for testicular biopsy, would be useful. Inhibin B and anti-Müllerian hormone (AMH) act as a direct marker of Sertoli cell function and indirect marker of spermatogenesis. We assessed the relationship between serum hormone levels based on Sertoli cell, Leydig cell, and gonadotropin and G/T in cryptorchidism with an infertility risk according to the pretreatment undescended testicular positions.
What We Found: Serum inhibin B levels and G/T were significantly lower in bilateral than in unilateral cryptorchid boys. In bilateral cryptorchid boys aged ≤24 months at orchidopexy inhibin B/follicle-stimulating hormones (FSH) and AMH/FSH ratios were positively collated with G/T, whereas serum hormones levels and G/T did not differ with the pretreatment testicular position in unilateral cryptorchid boys.
Limitations: This is a retrospective mode of data collection with no paternity or semen data. There were no healthy controls for serum hormone levels and germ cell count evaluation data.
Interpretations for Patient Care: In bilateral cryptorchid boys aged ≤24 months at orchidopexy, inhibin B/FSH and AMH/FSH ratios provided valuable information on G/T. In contrast, serum hormone levels did not reflect G/T in unilateral cryptorchid boys. Bilateral cryptorchid boys with low inhibin B/FSH and AMH/FSH ratios would have potential for future infertility risk. These ratios may guide decisions regarding a closer and longer followup or need for additional hormone therapy after orchidopexy.