Role of GERM cell apoptosis and serum inhibin b as prognostic markers of fertility in children with undescended testis

ABSTRACT

Undescended testis is a common congenital abnormality in children that contributes to impaired fertility in adulthood. This work aims at evaluating germ cell apoptosis as well as serum inhibin B as prognostic markers of fertility potential in cryptorchid children aged less than 2 years. Methods: The study included 32 children with unilateral undescended testis, divided into 3 age groups group 1 [3<6 months], group 2 [6 - < 12 months] and group 3 [12 - 24 months]. Control group included 22 healthy age-matched boys. Serum inhibin B, testosterone, follicle stimulating hormone [FSH] and luteinizing hormone [LH] were measured in all subjects. Testicular biopsies from cryptorchid boys were examined histologically and by immunohistochemistry for Fas expression. Serum FSH and LH were significantly lower in cryptorchid infants in age group 1 compared to controls [p = 0.03 and 0.04 respectively]. This was accompanied by defective transformation of gonocytes into adult spermatogonia. In age groups 2 and 3, inhibin B was significantly lower in cryptorchid boys than their age-matched controls [p = 0.014 and 0.01 respectively], while the very low serum testosterone was not significantly different between patients and controls. An age-related decrease in inhibin B was paralleled with delayed Sertoli cell development in age groups 2 and 3. Fas expression in germ cells increased with increasing age until the age of 18 months, while in older children, it was markedly reduced. Serum Inhibin B may be used as a marker for the integrity of the seminiferous epithelium in unilaterally cryptorchid boys and may be considered a predictive marker for future spermato gene sis, especially when supplemented with histological data on germ cell development and apoptosis