Lack of functional compensatory activity of the seminiferous tubules remaining testis in monorchid boys

GRINSPON ROMINA; HABIB CAROLINA; MARÍA GABRIELA ROPELATO; MARÍA GABRIELA BALLERINI; BEDECARRÁS , PATRICIA; GOTTLIEB S.; REY , RODOLFO

Milan

Congreso; 9th Joint Meeting of Paediatric Endocrinology; 2013

ESPE

Abstract Text: Background: Monorchia is the existence of only one testis and occurs in 4% of cryptorchid patients. In congenital cases the presence of vas deferens and epididymis supports the existence of testicular tissue in the first 16 weeks of gestation. It can be the result of a spontaneous pre- or post-natal degeneration of one testis, orchiectomy for testicular diseases or testicular degeneration following surgery. The remaining testis usually undergoes compensatory hypertrophy. It is not clear if it can also compensate the function of the absent one. Objective: The aim of this study was to investigate testicular function in monorchid boys. Methods: In a retrospective semi-longitudinal study, we compared serum AMH, testosterone, FSH and LH between 89 monorchid patients (119 samples), ages 1.1-18.7 yr, and 421 normal boys. Only one sample was included in each age group. Comparisons were performed using the Mann Whitney test. Results: In monorchid boys, AMH (pmol/l, median and interquartile range) was: 6m-2.9 yr: 324 (221-820), 3-9 yr: 403 (203-637), 9-10.9 yr: 330 (196-446), 11-12.9 yr: 165 (62-281), 13-14.9: 48 (30-67), >15 yr: 37 (20-44), showing a significant reduction in all groups except 11-12.9 yr; 34% of the samples were <3rd centile. FSH was significantly elevated in all patients > 13 yr. FSH was >97th centile in 9% of monorchid patients <9 yr and 27% of patients >9 yr. LH was significantly elevated in groups 11-12.9 yr and >15 yr. LH was >97th centile in 22% of monorchid patients <9 yr and 12% of patients > 9 yr. Testosterone was significantly reduced only in monorchid patients 9-12.9 yr; 16% of monorchid patients >13 yr had testosterone <3rd centile. Similar results were observed when the analysis was performed according to Tanner stages. A subgroup of 20 monorchid patients in whom a history compatible with gonadal damage of the remaining testis could be ruled out was analyzed: AMH was significantly reduced as compared to age-matched controls in all groups except the 11-12.9 yr and >15 yr. Conclusions: AMH reduction and FSH increase indicates that the remaining testis does not compensate the function of the absent one. Furthermore, results in patients with no history compatible with gonadal damage of the remaining testis rule out that reduced AMH is related to the concomitant dysfunction of the remaining testis.