Effect of LH-RH treatment on hypothalamo-pituitary-gonadal axis and Leydig cell ultrastructure in cryptorchid boys.

62 cryptorchid boys aged 2-6 years were selected at random either for surgical or for hormonal LH-RH treatment. As all biopsies from boys operated show typical histological and ultrastructural signs of cryptorchidism, it can be concluded that only true cryptorchid patients are included in our study. LH-RH treatment was successful in 16 (55%) of 31 boys. Median 30-min response values to LH-RH test of LH were initially normal in all boys. Those treated successfully remain normal after treatment whereas unsuccessfully treated patients have significantly lower LH 30-min response values at the end of the 4 weeks of LH-RH treatment. FSH response was not statistically different before or after treatment. This might indicate that a normal LH response is necessary for testicular descent. In the 15 boys operated after 4 weeks of unsuccessful LH-RH treatment, testes biopsies show recruitment of the Leydig cell precursors and development of juvenile Leydig cells with an increase in their content of lipoid droplets and smooth endoplasmic reticulum. No adverse effect on the number of spermatogonia could be observed after 4 weeks of LH-RH treatment.