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The hypothalamus-pituitary-testis axis in boys during the first six months of life: a comparison of cryptorchidism and hypospadias cases with controls.

Pierik FH; Deddens JA; Burdorf A; de Muinck Keizer-Schrama SMPF; de Jong FH; Weber RF
Int J Androl 2009 Oct; 32(5):453-461
It is inconclusive whether the feedback mechanisms of the hypothalamus-pituitary-testis (HTP) axis are already established in the first 6 months of life, partly due to the dramatic changes in HPT-axis hormone levels over this period. Moreover, it is unclear whether these hormone levels are aberrant in boys with cryptorchidism or hypospadias, and therefore predictive for future fertility. We studied the regulation mechanisms of the HTP axis, and the effect of age, in boys 1-6 months of age. Secondly, we studied testicular function - as reflected by HPT hormones - in newborns with cryptorchidism or hypospadias. Sera from a population sample of infants with cryptorchidism (n = 43), hypospadias (n = 41) and controls (n = 113) were analyzed for inhibin B, anti-Mullerian hormone (AMH), testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH) and sex hormone binding globulin (SHBG). LH, testosterone, non-shbg-bound testosterone (NSBT), and AHM levels showed significant age-related trends. After age-correction, a negative correlation between FSH and inhibin B was observed (r = -0.43). The only significant group-differences were lower testosterone and NSBT levels in cryptorchidism cases, with a mean testosterone of 1.8 and 2.6 nmol/L and a mean NSBT of 0.48 and 0.70 nmol/L for cryptorchidism cases and controls, respectively. The higher levels of LH, testosterone, and NSBT in boys born pre-term or with a low birthweight indicate that abnormal prenatal development may determine postnatal testis function. Our results support the hypothesis that the inhibin B - FSH feedback loop is already functional before puberty. The lower testosterone and NSBT levels indicate that disturbed Leydig cell function can already be detected early after birth in cryptorchid boys.
Age-groups; Cell-biology; Cell-function; Cell-morphology; Cellular-function; Children; Hormone-activity; Reproductive-system-disorders; Statistical-analysis; Testes; Author Keywords: AHM; cryptorchidism; FSH; hypospadias; inhibin B; LH; newborn boys; testosterone
Frank H. Pierik, Department of Andrology, Erasmus MC, Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
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International Journal of Andrology
Page last reviewed: September 2, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division