Assessment of testicular function using direct and indirect markers of Sertoli cell in prepubertal boys with bilateral cryptorchidism.

GRINSPON R; ANDREONE L; BERGAD¨¢ I; GOTTLIEB S.; LORETI N; BEDECARR¨¢S P; ROPELATO MG; REY R.; CAMPO S

Lima

Congreso; Sociedad Latinoamericana de Endocrinolog¨ªa Pedi¨¢trica SLEP; 2008

Sociedad Latinoamericana de Endocrinolog¨ªa Pedi¨¢trica

In childhood, testicular function can be evaluated studying the tubular compartment. The aim of this study was to assess tubular function of bilaterally cryptorchid patients using direct and indirect markers of Sertoli cell function. We evaluated serum levels of anti-M¨¹llerian Hormone (AMH), inhibin B (InhB) and inhibin subunit Pro-¦ÁC by ELISA, and FSH by IFMA in 70 prepubertal boys (5¡À3.6 years) with bilateral cryptorchidism before surgery. AMH, InhB and FSH were normal in 13 patients (19%, 4.7¡À3.3 yr). AMH and InhB were below normal in 42 patients showing primary tubular damage, with elevated FSH in 13 patients (19%, 4.4¡À3.0 yr) and normal FSH in 29 patients (41%, 5.0¡À3.6 yr). Within this group, non detectable InhB coexisted with low Pro-¦ÁC in 12 cases and with low AMH in 14. Probably, when tubular damage is severe, inhibin bB expression is affected more readily. Correlation between AMH and InhB was significant (Spearman r 0.73, P<0.0001, n=70), indicating high concordance for tubular assessment. However, AMH was low and InhB was normal in 14 patients (20%, 4.6¡À3 yr). AMH may detect a testicular damage earlier than inhibin B or may present more false positive results. Conclusions: Serum InhB and AMH show a significant concordance as tubular damage markers in patients with bilateral cryptorchidism. When tubular damage is severe, the coexistence of non detectable InhB with detectable AMH reflects the different regulation between these two Sertoli cell peptides.