Association between altered placental human chorionic gonadotrophin (hCG) production and the occurrence of cryptorchidism: a retrospective study

BMC Pediatrics

Régis Coutant³  Stéphanie Rouleau³  Dominique Weil²  Hugues Puissant¹  Carole Chedane³ 

[1]Department of Genetics, University Hospital, Angers, France

[2]Department of Pediatric Surgery, University Hospital, Angers, France

[3]Department of Pediatric Endocrinology, University Hospital, 4 rue Larrey, 49033 Angers CEDEX 01, France

关键词: hCG;    Males;    Cryptorchidism;   

Others  :  1135414
DOI  :  10.1186/1471-2431-14-191

 received in 2013-11-16, accepted in 2014-07-22,  发布年份 2014

【 摘 要 】

Background

An increase in cryptorchidism has been reported in many countries. One mechanism could be low fetal testosterone production possibly secondary to altered placental human chorionic gonadotrophin (hCG) release. Our Objective was to compare hCG values from maternal blood between boys with cryptorchidism and normal boys.

Methods

Total hCG and α-fetoprotein (AFP) values [12–16 weeks of gestation; from the double test for Down syndrome screening) were compared between cases of cryptorchidism and normal control boys who were matched for maternal age, maternal smoking, gestational age at time of hCG measurement (±1 day), birth weight and birth term. Measurements were performed in a single laboratory; values were expressed as absolute values (KU/L) and multiples of the median (MoM). Boys whose mothers had had a complicated pregnancy were excluded. Groups were compared using the Student’s t test. Log transformation was used to normalize hCG, MoM hCG, AFP and MoM AFP distribution, and values were expressed as geometric means (-1, + 1 tolerance factor).

Results

Total hCG and MoM hCG levels were significantly lower in the 51 boys with cryptorchidism compared to 306 controls (21.4 (12.3; 37) KU/L vs 27.7 (15.9; 47.9) KU/L and 0.8 (0.5; 1.2) MoM vs 1.0 (0.6; 1.6) MoM, respectively, p < 0.01). By contrast, AFP and MoM AFP levels were similar between groups.

Conclusion

This study showed a link between low maternal serum hCG levels and cryptorchidism in boys from uncomplicated pregnancy, while normal AFP levels indicated a normal fetoplacental unit. Whether these abnormalities were due to endogenous or exogenous factors remains to be determined.

【 授权许可】

   
2014 Chedane et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Paulozzi LJ: International trends in rates of hypospadias and cryptorchidism. Environ Health Perspect 1999, 107:297-302.
• [2]Akre O, Lipworth L, Cnattingius S, Sparen P, Ekborn A: Risk factor patterns for cryptorchidism and hypospadias. Epidemiology 1999, 10:364-369.
• [3]Willingham E, Baskin LS: Candidate genes and their response to environmental agents in the etiology of hypospadias. Nat Clin Pract Urol 2007, 4:270-279.
• [4]Scott HM, Mason JI, Sharpe RM: Steroidogenesis in the fetal testis and its susceptibility to disruption by exogenous compounds. Endocr Rev 2009, 30:883-925.
• [5]Achermann JC, Hughes IA: Disorders of sex development. In Williams textbook of Endocrinology. Edited by Konenberg HM, Melmed S, Polonsky KS, Reed Larsen P. Saunders Elsevier; 2012:783-848.
• [6]Vigueras RM, Reyes G, Moreno-Mendoza N, Merchant-Larios H: Gubernacular fibroblasts express the androgen receptor during testis descent in cryptorchid rats treated with human chorionic gonadotrophin. Urol Res 2004, 32:386-390.
• [7]Welsh M, Saunders PT, Fisken M, Scott HM, Hutchison GR, Smith LB, Sharpe RM: Identification in rats of a programming window for reproductive tract masculinization, disruption of which leads to hypospadias and cryptorchidism. J Clin Invest 2008, 118:1479-1490.
• [8]Newbold RR: Lessons learned from perinatal exposure to diethylstilbestrol. Toxicol Appl Pharmacol 2004, 199:142-150.
• [9]Siler-Khodr TM, Khodr GS, Valenzuela G, Rhode J: Gonadotropin-releasing hormone effects on placental hormones during gestation: II. Progesterone, estrone, estradiol and estriol. Biol Reprod 1986, 34:255-264.
• [10]Rama S, Rao AJ: Embryo implantation and GnRH antagonists. The search for the human placental GnRH receptor. Hum Reprod 2001, 16:201-205.
• [11]Kiely EA, Chapman RS, Bajoria SK, Hollyer JS, Hurley R: Maternal serum human chorionic gonadotrophin during early pregnancy resulting in boys with hypospadias or cryptorchidism. Br J Urol 1995, 76:389-392.
• [12]Burton M, Davies T, Raggatt P: Undescended testis and hormone levels in early pregnancy. J Epidemiol Comm Health 1987, 41:127-129.
• [13]Bernstein L, Pike M, Depue R, Ross RK, Moore JW, Henderson BE: Maternal hormone levels in early gestation of cryptorchid males: a case–control study. Br J Cancer 1988, 58:379-381.
• [14]Wald NJ, Cuckle HS, Densem JW, Nanchahal K, Royston P, Chard T, Haddow JE, Knight GJ, Palomaki GE, Canick JA: Maternal serum screening for Down’s syndrome in early pregnancy. BMJ 1988, 297:883-887.
• [15]Wald NJ, Cuckle HS, Densem JW, Kennard A, Smith D: Maternal serum screening for Down's syndrome: the effect of routine ultrasound scan determination of gestational age and adjustment for maternal weight. Br J Obstet Gynaecol 1992, 99:144-149.
• [16]Boyd HA, Myrup C, Wohlfahrt J, Westergaard T, Norgaard-Pedersen B, Melbye M: Maternal serum alpha-fetoprotein level during pregnancy and isolated cryptorchidism in male offspring. Am J Epidemiol 2006, 164:478-486.