THE RETRACTILE TESTIS CAN BE A CAUSE OF ADULT INFERTILITY

Objective: To determine the functional state of the testes of young ad ults treated for small and hypotrophic retractile testis at prepuberta l age by orchiopexy and/or hormonal therapy and the functional state o f the testes of adults with retractile testis. Design: Spermiogram and transmission electron microscopy (TEM) study of the semen. Light micr oscopic and TEM studies of semen and testicular biopsies of adults wit h retractile testis were performed. Setting: Division of Pediatric Sur gery in an academic environment. Patient(s): Thirty-eight young adults (mean age, 18 gears) treated for retractile testis at prepubertal age and seven adults (mean age, 28 years) with retractile testis. Interve ntion(s): Two cycles of hCG, followed by surgical therapy (orchiopexy) when unsuccessful. Main Outcome Measure(s): Fertility of young adults treated for retractile testis at prepubertal age. Result(s): Only 8 o f 38 (21%) young adults had normal spermiograms. Five of 38 (13%) were azoospermic and 25 of 38 (66%) were oligoasthenozoospermic with ultra structural signs of altered maturation of the sperm and a higher numbe r of atypical forms. Of the adults with retractile testis, 2 of 7 (28. 5%) were normal, 3 of 7 (43%) were oligoasthenozoospermic, and 2 of 7 (28%) were azoospermic. Conclusion(s): Our data support the hypothesis that prepubertal retractile testis showing signs of reduced consisten cy and size is a risk factor for adult infertility and requires treatm ent. (C) 1997 by American Society for Reproductive Medicine.