Pituitary and gonadal function in prepubertal and pubertal cryptorchidism.

LRH and hCG tests were performed in 35 prepubertal and 35 pubertal boys with unilateral or bilateral cryptorchidism to examine the pituitary and gonadal function. Twenty-one normal boys were also examined as controls. In the prepubertal group, distinct increases in serum LH, FSH and testosterone levels by LRH and hCG tests were found in all of the normal and unilateral cryptorchid boys. However, no or very little response was observed in 4 out of 17 boys with bilateral cryptorchidism. In the pubertal group, serum levels of LH, FSH and testosterone in normal boys, in unilateral and in bilateral cryptorchid boys were evidently higher than those in the prepubertal group, and distinct or moderate responses by the LRH and hCG tests were found in all boys examined. Although serum testosterone levels were similar in all groups, serum basal and peak gonadotrophin levels by the LRH test were significantly higher in bilateral cryptorchid boys than in normal and unilateral cryptorchid boys. The difference was more marked in FSH than in LH level. An elevated level of serum LH is suggestive of the hypofunction of not only the seminiferous tubules but also of the Leydig cells in cryptorchid testes.