Re: Commentary on “Testis tissue cryopreservation may be considered in boys with cryptorchidism”

Dear Editor,

We are much obliged that Hadziselimovic1 has used our data2 to highlight the substantial proportion of boys with cryptorchidism where gonadotropin insufficiency is an important factor related to the pathogenesis.

We have recently presented a study on a series of 453 consecutive boys with bilateral nonsyndromic cryptorchidism, in which we conducted hormonal evaluations and assessed germ cell numbers in testicular biopsies.3 In this series, 45% of the boys were classified as having gonadotropin insufficiency.3 Identifying these patients at the time of surgery is important. A recent follow-up study of 208 boys with nonsyndromic bilateral cryptorchidism from our department showed that the boys with gonadotropin insufficiency had an impaired fertility potential after surgery compared to boys with an intact hypothalamus–pituitary–gonadal feedback mechanism.4 In a review from 2022, Hadziselimovic5 suggested that infertility in patients diagnosed with cryptorchid testes is a consequence of a hormonal deficiency rather than temperature-induced cellular damage.

In one of our recent review articles,6 we provided partial support for the hypothesis proposed by Hadziselimovic. Some cases were shown to deteriorate further after surgery. This highlights the importance of offering cryopreservation for testicular biopsies as a means to preserve germ cells while they are still present in early childhood. Although the final step to transform these germ cells into functional haploid cells for fertility restoration in human males has not yet been established, early preservation remains crucial.2

COMPETING INTERESTS

All authors declare no competing interests.