Commentary on: Biers SM, Malone PS. A critical appraisal of the evidence for improved fertility indices in undescended testes after gonadotrophin-releasing hormone therapy and orchidopexy. J Pediatr Urol

Abstract

The authors of this review provided a good summary of the literature on the role of gonadotrophin-releasing hormone therapy in undescended testis. Their article opens with the evidence for abnormal germ cell development in undescended testes, and then describes the evidence in support of hormone therapy for cryptorchidism. The literature is divided into those papers describing pre-orchidopexy and post-orchidopexy gonadotrophin treatment, including combined with human chorionic gonadotrophin treatment. They then summarize the evidence against use of hormone therapy, and despite the fact that there are no randomized, controlled trials showing that gonadotrophin treatment is effective in preventing infertility, the authors suggest that the evidence is sufficiently strong to recommend a change in clinical practice.