Compensatory function of the remaining testis is dissociated in boys and adolescents with monorchidism

HABIB CAROLINA; REY RA; GRINSPON R.; GOTTLIEB S.; BEDECARRAS PATRICIA

EUROPEAN JOURNAL OF ENDOCRINOLOGY

BIOSCIENTIFICA LTD

Lugar: Bristol; Año: 2016 vol. 174 p. 399 - 407

0804-4643

Objective: Compensatory hypertrophy has been classically described in patients with monorchidism. However, it remainsunclear whether there is a functional compensatory activity of the different cell populations. Our aim was to assess thefunctional capacity of the solitary testis in monorchid males from infancy through puberty in order to determine whetherthe remaining gonad is capable of compensating the functional activity of Sertoli and Leydig cells of the absent gonad.Design: In a retrospective, cross-sectional, analytical study performed at a tertiary paediatric public hospital, we included89 boys with monorchidism and 358 healthy controls, aged 6 months?18 years. Testicular volume and circulating levels ofreproductive hormones were compared between patients with monorchidism and normal boys. Serum anti-Mu¨ llerianhormone (AMH) and FSH were used as biomarkers of the functional mass of prepubertal Sertoli cells, whereas serumtestosterone and LH were used as biomarkers of Leydig cells.Results: In the vast majority of the cases, the testicular volume of monorchid boys was smaller than the sum of the volumeof both testes of healthy controls. Serum AMH was lower and FSH was higher in patients with monorchidism than in controlsaged !3 and O13 years. Serum testosterone and LH did not differ significantly between patients and controls.Conclusion: In boys and adolescents with monorchidism, there is a dissociated capacity of the remaining testis to compensatefor the absence of the other gonad: while Leydig cell function is largely compensated, Sertoli cell proliferation and functionwas lower than in controls.