Chinese Journal of Evidence -Based Pediatric ›› 2015, Vol. 10 ›› Issue (6): 438-442.

• Original Papers • Previous Articles     Next Articles

Impact of the adjunctive hormonal therapy on testicular spermatogenic function among cryptorchid: a systematic review and meta-analysis

ZHANG Su,WANG Cheng, FU Sheng-jun,YANG Li   

  1. Department of Urology, the Second Hospital of Lanzhou University,Institute of Urology of Lanzhou University, Key Laboratory of Diseases of Urological System in Gansu Province, Gansu Nephron-Urological Clinical Center, Lanzhou 730030, China
  • Received:2015-11-02 Revised:2015-12-24 Online:2015-12-05 Published:2015-12-04
  • Contact: YANG Li


Objective To systematically evaluate the effect of hormonal therapy on testicular spermatogenic function of children with cryptorchidism. Methods PubMed, EMBASE, The cochrane library, CBM, CNKI, WanFang Date and VIP were searched to collect relevant studies investigating the impact of hormonal therapy in the testicular spermatogenic function among cryptorchid.Two reviewers independently screened literatures, extracted data, and assessed the risk bias of included studies. As the short-term indicator, the spermatogonia per tubule(S/T) was expressed as mean difference(MD) and its 95% confidence intervals(CI). For the long-term indicator, the proportion of cryptorchidism who will have a normal sperm concentration in adulthood was expressed as risk ratio(RR) with 95% CI.The meta-analysis was performed using RevMan 5.3 software.A fixed-effect model or a random-effect model would be used acording to the heterogeneity. Results A total of 4 RCTs(n=168) and 4 Non-randomized controlled trials(NRCT) (n=248) were included. All of these studies had high risk of bias.Among them,3 studies reported the S/T of HCG+surgery group and surgery alone group,the fixed-effect model showed that hCG had decreased the S/T, MD=-0.08,95%CI: -0.13 to -0.03), P=0.002. Four studies was pooled in the meta-analysis using random-effect model. It showed that compared with surgery alone group, LHRH+surgery group had increased S/T, MD=0.34, 95%CI: 0.04 to 0.64, P=0.03, and subgroup analysis indicated the same effect in unilateral or bilateral cryptorchid. Compared with cryptorchid treated by surgery alone, the hCG+LHRH+surgery group did not increase the rate of sperm concentration with the normal range among patients who had history of cryptorchidism, RR=1.46,95%CI:0.24 to 9.06, P=0.68. Conclusion Cryptorchid boys treated with hCG show damage in short-term testicular spermatogenic function, and LHRH would improve it. There is no evidence that combined usage of HCG ad LHRH will benefit long-term sperm concentration. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.

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