A case-control study of cryptorchidism and maternal hormone concentrations in early pregnancy.

Tja Key,D Bull,Gmg Clark,Mc Pike,P Ansell,Jw Moore,Ar Brett,Ced Chilvers

doi:10.1038/bjc.1996.121

Abstract

Serum samples taken between 6 and 20 weeks of gestation were obtained from 28 mothers who gave birth to cryptorchid sons (cases) and from 108 control mothers. In comparison with controls the cases had 10% higher geometric mean oestradiol (95% CI -13% to +39%: P=0.42) and 10% lower geometric mean testosterone (95% CI -27% to +10%: P=0.30). Among the samples collected between 6 and 14 weeks of gestation geometric mean concentrations of oestradiol and testosterone were 5% lower (95% CI -32% to +31%: P=0.74) and 25% lower (95% CI -45% to +1%: P=0.06) respectively in cases than in controls. Among the samples collected between 15 and 20 weeks of gestation geometric mean concentrations of oestradiol and testosterone were 29% higher (95% CI -8% to +79%: P=0.14) and 21% higher (95% CI -8% to +60%: P=0.18) respectively in cases than in controls. The results do not support the hypothesis that cryptorchidism may be caused by high concentrations of oestradiol in the maternal blood during the first phase of testicular descent, but suggest that the possible association of cryptorchidism with low maternal testosterone during early gestation should be further investigated.

Highlights

We describe the relationships of maternal oestradiol and testosterone with parity, cigarette smoking and other possible risk factors for cryptorchidism
Geometric mean oestradiol, adjusted for birthweight and week of gestation, was 10% higher in cases than in controls
Bernstein et al (1986) suggested that the higher oestradiol levels in first pregnancies could be responsible for the higher risk of cryptorchidism associated with sons being firstborn in some studies, but our results suggest the possibility that any such tendency might be counteracted by higher testosterone levels in first pregnancy

Summary

Methods

The subjects were a subset of participants in a questionnairebased case - control study of cryptorchidism in Oxfordshire. Cases and controls were identified from a cohort of 7500 boys examined shortly after birth by specially trained research nurses (John Radcliffe Hospital Cryptorchidism Study Group, 1992). Cryptorchidism at birth was defined by position (John Radcliffe Hospital Cryptorchidism Study Group, 1988). All boys with cryptorchidism at birth were re-examined at 3 months of age, since in approximately 70% of boys who are cryptorchid at birth the testes descend spontaneously by 3 months of age (John Radcliffe Hospital Cryptorchidism Study Group, 1992). Only boys who were cryptorchid both at birth and at 3 months were accepted as cases.

Results

Discussion

Conclusion