Fertility potential after unilateral and bilateral orchidopexy for cryptorchidism.

OBJECTIVES: The aim of the study was to compare fertility potential in patients who had been operated upon in childhood because of unilateral or bilateral cryptorchidism.

METHODS: The study covered 68 men (age 25-30 years) with a history of unilateral (49) or bilateral orchidopexy (Mandat et al. in Eur J Pediatr Surg 4:94-97, 1994). Fertility potential was estimated with semen analysis (sperm concentration, motility and morphology), testicular volume measurement and hormonal status evaluation [follicle-stimulating hormone (FSH) and inhibin B levels]. Differences were analysed with the nonparametric Mann-Whitney test.

RESULTS: The group of subjects with bilateral orchidopexy had significantly decreased sperm concentration (P = 0.047), sperm motility (P = 0.003), inhibin B level (P = 0.036) and testicular volume (P = 0.040), compared to subjects with unilateral orchidopexy. In the group with bilateral orchidopexy, there was a strong negative correlation between inhibin B and FSH levels (P < 0.001, r (s) = -0.772). Sperm concentration in this group correlated positively with inhibin B level (P = 0.004, r (s) = 0.627) and negatively with FSH level (P = 0.04, r (s) = -0.435). The group of subjects with unilateral orchidopexy who had been operated before the age of 8 years had significantly increased inhibin B level (P = 0.006) and testicular volume (P = 0.007) and decreased FSH level (P = 0.01), compared to subjects who had been operated at the age of 8 or later.

CONCLUSIONS: Men who underwent bilateral orchidopexy in their childhood have appreciably poorer prognosis for fertility compared to men who underwent a unilateral procedure. Our study also confirmed that men who underwent unilateral orchidopexy in their childhood before the age of 8 years have better prognosis for fertility compared to those who were operated later.