European Journal of Pediatrics

, Volume 146, Supplement 2, pp S2–S5 | Cite as

The pituitary-gonadal axis in cryptorchid infants and children

  • J. C. Job
  • J. E. Toublanc
  • J. L. Chaussain
  • D. Gendrel
  • M. Roger
  • P. Canlorbe


We have attempted to document in cryptorchid children that there is an LH deficiency and a secondary deficiency of testosterone. We have shown a diminished LH peak after LH-RH in cryptorchid versus normal infants (P<0.05). The postnatal surge of testosterone is significantly low (P<0.001) in permanent cryptorchids versus infants with secondary testicular descent, whose levels are similar to those in controls. In permanent cryptorchids during the same period (0–4 months), LH and testosterone levels were significantly lower (P<0.01 and P<0.05 respectively) than in infants with secondary descent, and the levels of testosterone and LH were correlated in both populations. In children, a low basal level of LH was observed at pubertal stage P2, and LH peak after LH-RH was significantly reduced at stages P1 and P2 (P<0.01 and P<0.05 respectively). The post-stimulatory levels of testosterone after hCG were reduced at the same stages (P<0.01, P<0.05), and the two levels were correlated (P<0.01). No differences are seen for LH and testosterone afterwards. It has been possible to show by immunofluorescence on pituitary cells the occurrence of antigonadotropin cell antibodies (AGCA) in more than 50% of our patients, with no relation to age and no correlations between endocrinological data and the presence or absence of AGCA. The relatively low success rate of hCG treatment, mainly in young children, and of GnRH irrespective of the regimen, of treatment, does not exclude the role of primary LH deficiency in cryptorchidism.

Key words

Testosterone LH, LH-RH Antigonadotropin cell antibody Immunity hCG treatment GnRH treatment 



antigonadotropin cell antibodies


  1. 1.
    Bierich JR, Giarola A (1979) Cryptorchidism. Academic Press, New York LondonGoogle Scholar
  2. 2.
    Bierich JR, Rager K, Ranke A (1977) Maldescensus testis. Urban & Schwarzenberg, MünchenGoogle Scholar
  3. 3.
    Canlorbe P, Toublanc JE, Roger M, Job JC (1974) Etude de la fonction endocrine du testicule dans 125 cas de cryptorchidie. Ann Méd Interne (Paris) 125:365–372Google Scholar
  4. 4.
    De Muinck Keizer S, Hazebrock FWJ, Matroos, AW, Drop SLS, Molenaar JC, Visser HKA (1986) Double-blind placebo controlled study of LH-RH nasal spray in treatment of undescended testes. Lancet I:876–879Google Scholar
  5. 5.
    Fonkalsrud EW, Mengel W (1981) The undescended testis. Year Book Medical Publishers, ChicagoGoogle Scholar
  6. 6.
    Garagorri JM, Job JC, Canlorbe P, Chaussain JL (1982) Results of early treatment of cryptorchidism with human chorionic gonadotropin. J Pediatr 101:923–927Google Scholar
  7. 7.
    Gendrel D, Roger M, Chaussain JL, Canlorbe P, Job JC (1977) Correlation of pituitary and testicular response to stimulation tests in cryptorchid children. Acta Endocrinol (Copenh) 86:641–646Google Scholar
  8. 8.
    Gendrel D, Job JC, Roger M (1978) Reduced post-natal rise of testosterone in plasma of cryptorchid infants. Acta Endocrinol (Copenh) 89:372–377Google Scholar
  9. 9.
    Gendrel D, Roger M, Job JC (1980) Plasma gonadotropins and testosterone values in infants with cryptorchidism. J Pediatr 97: 217–220Google Scholar
  10. 10.
    Gendrel D, Chaussain JL, Roger M, Job JC (1980) Simultaneous postnatal rise of plasma LH and testosterone in male infants. J Pediatr 97:600–602Google Scholar
  11. 11.
    Hadziselimovic F, Herzog B (1976) The meaning of the Leydig cell in relation to the etiology of cryptorchidism. An experimental electron-microscopic study. J Pediatr Surg 11:1–8Google Scholar
  12. 12.
    Hadziselimovic F, Herzog B, Segushi H (1975) Surgical correction of cryptorchidism at 2 years. Electron microscopic and morphometric investigations. J Pediatr Surg 10:19–29Google Scholar
  13. 13.
    Job JC (1979) Cryptorchidism, diagnosis and treatment. Karger, BaselGoogle Scholar
  14. 14.
    Job JC, Gendrel D (1982) Endocrine aspects of cryptorchidism. In [20], pp 353–360Google Scholar
  15. 15.
    Job JC, Garnier PE, Chaussain JL, Toublanc JE, Canlorbe P (1974) Effect of synthetic LH-RH in hypophyso-gonadal disorders of children and adolescents. IV. Undescendes testes. J Pediatr 84: 371–374Google Scholar
  16. 16.
    Job JC, Gendrel D, Safar A, Roger M, Chaussain JL (1977) Pituitary LH and FSH and testosterone secretion in infants with undescended testes. Acta Endocrinol (Copenh) 85:644–649Google Scholar
  17. 17.
    Job JC, Canlorbe P, Garagorri JM, Toublanc JE (1982) Hormonal therapy of cryptorchidism with hCG. In [20], pp 405–411Google Scholar
  18. 18.
    Job JC, Joab N, Safar A, Canlorbe P (1987) Effects de la gonadoliberine (LHRH) par voie nasale chez les enfants cryptorchides de l à 6 ans. Arch Fr Pediatr 44:91–95Google Scholar
  19. 19.
    Pouplard A, Job JC, Luxembourger I, Chaussain JL (1985) Antigonadotropin cell antibodies in the serum of cryptorchid children and infants and of their mothers. J Pediatr 107:26–30Google Scholar
  20. 20.
    Rajfer J (1982) Symposium on Crytorchidism. Urol Clin NOrth Am 9, no 3Google Scholar
  21. 21.
    Rajfer J, Handelsman D, Swerdloff RS, Hurwitz R, Kaplan H, Vandergast T, Ehrlich RM (1986) Hormonal therapy of cryptorchidism. A randomized double-blind study comparing hCG and Gn RH. N Engl J Med 314:466–470Google Scholar
  22. 22.
    Steinberger E, Root A, Fischer M, Smith K (1973) The role of androgens in the initiation of spermatogenesis in man. J Clin Endocrinol Metab 37:746–752Google Scholar
  23. 23.
    Waaler PE (1976) Endocrinological studies in uneescended testis. Acta Paediatr Scand 65:559–568Google Scholar

Copyright information

© Springer-Verlag 1987

Authors and Affiliations

  • J. C. Job
    • 1
  • J. E. Toublanc
    • 1
  • J. L. Chaussain
    • 1
  • D. Gendrel
    • 1
  • M. Roger
    • 1
  • P. Canlorbe
    • 1
  1. 1.Hôpital Saint Vincent de PaulParisFrance

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