PURPOSE: One of the concerns regarding cryptorchidism is the risk of impaired fertility. Current guidelines recommend orchidopexy for cryptorchidism between 6 to 12 months to optimize the fertility outcome. The aim of this study was to evaluate the fertility potential of boys with non-syndromic cryptorchidism who underwent orchidopexy within the recommended age in order to clarify the need for eventual supplemental treatment modalities.

MATERIALS AND METHODS: A retrospective evaluation of mini-puberty hormones (follicle stimulating hormone, luteinizing hormone, and inhibin B) and testicular biopsies from boys with cryptorchidism who underwent early orchidopexy within the first year, between 2010 and 2019, was performed. Based on histological examination, the germ cell number and the type A dark (Ad) spermatogonia number per seminiferous tubule cross-section (G/T and AdS/T, respectively) were analyzed in relation to normal values.

RESULTS: 25% (83/333) of the boys with non-syndromic cryptorchidism (21% bilateral cryptorchidism) had reduced G/T. 21% of the boys (70/333) had low serum inhibin B. Of these boys having low serum inhibin B, 46% (32/70) boys had decreased G/T and 33% (23/70) boys decreased AdS/T (<0.01). Totally, 23% (75/333) of the boys had no Ad spermatogonia present.

CONCLUSIONS: Despite early and successful orchidopexy 20-25% of boys with cryptorchidism may risk later infertility based on hormonal and histological data. Blood test and testicular biopsies are mandatory to identify boys with a high risk of infertility where additional treatment modalities and follow-up may be needed.