EPIDEMIOLOGY OF MALE INFERTILITY: CRYPTORCHIDISM

隐睾症是男性不育的主要原因，但研究很少。 来自对在儿童医院接受治疗的一大群男性的研究 匹兹堡，我们已经确定未遂亲子关系在 以前的双侧和单侧隐睾人相比 控制。我们现在建议利用这一队列进一步评估风险 隐睾症后不孕症的因素和指标(特别是 精子和激素指标)来确定这种情况的效果， 其治疗方法和治疗年龄。不孕不育与 隐睾症可能是由于对细菌的渐进性、不可逆转的损害造成的 治疗前儿童时期未降睾丸的细胞，来自 手术矫正的效果，或来自这些的不同组合。 因为并不是所有的研究对象都尝试过亲子鉴定，我们建议 研究参数可以量化，这些参数与 可能对整个队列都有影响的亲子关系。我们 将检验如下假设：(1)精子质量和数量减少 隐睾症后表现为精子密度、精子总数、 (2)血清卵泡刺激素(FSH) 隐睾症男性体内的水平升高，反映了对 睾丸精子产生元素；(3)血浆睾酮，总的和 自由，在以前的隐睾症患者中由于睾丸的原因而减少 损伤；(4)矫正年龄的自变量 隐睾症，手术类型，前处理的位置和大小 未下降的睾丸与较差的精子参数有关，更多 升高FSH，降低睾酮和游离睾酮。本研究 将确定男性不育的预测因素(潜在预测因素-精子 参数、促卵泡成熟激素、睾酮、游离睾酮)，并评估其益处 隐睾症的治疗时间和治疗年龄。我们将数据提供给 验证我们建议测量的参数是否可以确定为 解决我们的假设。我们将使用我们已有的激素分析方法。 经验丰富，并能充分发现个体之间的差异。 精子分析将与生殖健康组织合作完成 网络包括用于计算机分析的精子运动的录像。这个 结果将提供隐睾症后生育能力的定义， 不仅为隐睾症的治疗提供了指南基础， 而是为以前的隐睾人提供治疗和咨询 生育能力。

Cryptorchidism is a major, but poorly studied, cause of male infertility. From studies of a large cohort of men treated at the Children's Hospital of Pittsburgh, we have determined that attempted paternity is decreased in both formerly bilateral and unilateral cryptorchid men compared with controls. We now propose to use this cohort to further assess risk factors and indicators of infertility after cryptorchidism (specifically sperm and hormone indicators) to determine the effect of this condition, its treatment and age of treatment. Infertility associated with cryptorchidism may result from progressive, irreversible damage to germ cells of the undescended testis during childhood prior to treatment, from effects of operative correction, or from various combinations of these. Because not all study subjects have attempted paternity, we propose to study parameters that can be quantified which are associated with paternity that will be potentially available for the entire cohort. We will test hypotheses that (1) sperm quality and quantity are diminished after cryptorchidism as reflected by decreased sperm density, total count, motility and morphology; (2) serum follicle-stimulating hormone (FSH) levels are elevated in cryptorchid men, a reflection of damage to testicular sperm producing elements; (3) plasma testosterone, total and free, is diminished in formerly cryptorchid men because of testicular injury; and (4) the independent variables of age of correction of cryptorchidism, type of surgery, location and size of the pretreatment undescended testes are associated with poorer sperm parameters, more elevated FSH and lower testosterone and free testosterone. This study will identify predictors of male infertility (potential predictors-sperm parameters, FSH, testosterone, free testosterone) and assess the benefit of treatment and age of treatment of cryptorchidism. We present data to verify that the parameters we propose to measure can be determined to address our hypotheses. We will use hormone assays with which we have experience and can sufficiently detect differences between individuals. Sperm analyses will be done in collaboration with the Reproductive Health Network including videotaping of sperm motility for computer analysis. The results will provide a definition of fertility after cryptorchidism, provide a basis for guidelines not only for treatment of cryptorchidism, but for treatment and counseling of formerly cryptorchid men concerning fertility.