Title: The Neoadjuvant Gonadotropin-Releasing Hormone Therapy Before Surgery and his Impact in Fertility Index in Undescended Testes: a Prospective Randomized Trial
Abstract: Purpose Cryptorchidism is a common condition with high risk of infertility. GNRH treatment appears to improve fertility later in life by inducing germ cell maturation. In a prospectively randomized trial we investigated whether preoperative GNRH therapy improves the fertility index in primary cryptorchidism. Material and Methods A total of 22 boys 12 to 123 months old (median 34.5) with 24 undescended testes were prospectively assigned to 2 groups during a 24-month period. Patients were randomized to receive either orchiopexy alone (12 patients) or with neoadjuvant GNRH therapy (12) as a nasal spray for 4 weeks at 1.2 mg per day. In both groups testicular biopsies were performed at the time of orchiopexy and histopathological fertility index was determined. Results Mean fertility index in the group treated with GNRH before surgery was significantly higher (0.88, SD +/- 0.31) compared to the group without hormonal stimulation (0.49, SD +/- 0.52, P = 0.02). There was no significantly correlation between fertility index in the GNRH group and the patient age. Conclusions Neoadjuvant GNRH treatment improves fertility index in prepubertal cryptorchidism and consequently should improve fertility in adulthood.
Publication Year: 2008
Publication Date: 2008-03-27
Language: en
Type: article
Indexed In: ['crossref']
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