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Postnatal activation of the hypothalamo-pituitary-gonadal axis (minipuberty) and undescended testicle


Authors: Vojtěch Fiala;  Zuzana Jirásková;  Marcel Drlík;  Anna-Marie Rappová;  Alžběta Kantorová;  Radim Kočvara
Authors‘ workplace: Urologická klinika Všeobecné fakultní nemocnice a 1. lékařské fakulty v Praze
Published in: Ces Urol 2021; 25(3): 182-192
Category: Review article

Overview

It is possible to measure higher hormonal activity (so called minipuberty) during first months of life, hormonal levels during this period are as high as in true puberty. The hypothalamo-pituitarygonadal axis is activated in both sexes, in boys the peak is between first and third month of life, in girls this period is longer. This hormonal surge has an important impact on the development of external genitalia and on gonadal maturation. Defective minipuberty is connected with failed transformation of spermatogonia in undescended testis, which may be one of reasons for future infertility in 30% of succesfully surgical only treated men. Further investigation of minipuberty and its hormonal substitution as an option how to improve infertility risk in these patients is necessary.

Keywords:

Cryptorchidism – Minipuberty – hypothalamo-pituitary-gonadal axis – hormonal analysis


Sources

1. Rohayem J, Luberto A, Nieschlag E, et al. Delayed treatment of undescended testes may promote hypogonadism and infertility. Endocrine 2017; 55(3): 914–924.

2. Verkauskas G, Malcius D, Eidukaite A, et al. Prospective study of histological and endocrine parameters of gonadal function in boys with cryptorchidism. J Pediatr Urol 2016; 12(4): 238.e1–6.

3. Verkauskas G, Malcius D, Dasevicius D, et al. Histopathology of Unilateral Cryptorchidism. Pediatr Dev Pathol 2019; 22(1): 53–58.

4. Thorup J, Clasen-Linde E, Dong L, et al. Selecting Infants With Cryptorchidism and High Risk of Infertility for Optional Adjuvant Hormonal Therapy and Cryopreservation of Germ Cells: Experience From a Pilot Study. Front Endocrinol (Lausanne) 2018; 9: 299.

5. Abacı A, Çatlı G, Anık A, et al. Epidemiology, classification and management of undescended testes: does medication have value in its treatment? J Clin Res Pediatr Endocrinol 2013; 5(2): 65–72.

6. Agarwal PK, Diaz M, Elder JS. Retractile testis: is it really a normal variant? J Urol 2006; 175(4): 1496–1499.

7. Docimo SG, Canning D, El-Khoury AE, et al. The Kelalis-King-Belman textbook of clinical pediatric urology. Sixth edition. Boca Raton: CRC Press 2017: 1150–1159.

8. Wein AJ, Kavoussi LR, Campbell MF. Campbell-Walsh urology: editor-in-chief, Alan J. Wein; [editors, Louis R. Kavoussi, et al.], 11th ed. Philadelphia, PA: Elsevier Saunders c2016: 3434–3441.

9. Kuijper EA, van Kooten J, Verbeke JI, et al. Ultrasonographically measured testicular volumes in 0- to 6-year-old boys. Hum Reprod 2008; 23(4): 792–796.

10. Lanciotti L, Cofini M, Leonardi A, et al. Up-To-Date Review About Minipuberty and Overview on Hypothalamic-Pituitary-Gonadal Axis Activation in Fetal and Neonatal Life Front Endocrinol (Lausanne) 2018; 9: 410.

11. Bergadá I, Milani C, Bedecarrás P, et al. Time course of the serum gonadotropin surge, inhibins, and anti-Müllerian hormone in normal newborn males during the first month of life. J Clin Endocrinol Metab 2006; 91(10): 4092–4098.

12. Chada M, Průsa R, Bronský J, et al. Inhibin B, follicle stimulating hormone, luteinizing hormone and testosterone during childhood and puberty in males: changes in serum concentrations in relation to age and stage of puberty. Physiol Res 2003; 52(1): 45–51.

13. Rey RA. Mini-puberty and true puberty: Differences in testicular function. Ann Endocrinol (Paris) 2014; 75(2): 58–63.

14. Chemes HE, Rey RA, Nistal M, et al. Physiological androgen insensitivity of the fetal, neonatal, and early infantile testis is explained by the ontogeny of the androgen receptor expression in sertoli cells. J Clin Endocrinol Metab 2008; 93: 4408–4412.

15. Kuiri-Hänninen T, Haanpää M, Turpeinen U, et al. Postnatal ovarian activation has effects in estrogen target tissues in infant girls. J Clin Endocrinol Metab 2013; 98(12): 4709–4716.

16. Jayasinghe Y, Cha R, Horn-Ommen J, et al. Establishment of normative data for the amount of breast tissue present in healthy children up to two years of age. J Pediat Adolesc Gynecol 2010; 23: 305–311.

17. Kuiri-Hänninen T, Seuri R, Erja Tyrväinen, et al. Increased Activity of the Hypothalamic-Pituitary-Testicular Axis in Infancy Results in Increased Androgen Action in Premature Boys. J Clin Endocrinol Metab 2011; 96(1): 98–105.

18. Hadziselimovic F. On the descent of the epididymo-testicular unit, cryptorchidism, and prevention of infertility. Basic Clin Androl 2017; 27: 21.

19. Becker M, Hesse V. Minipuberty: Why Does it Happen? Horm Res Paediatr 2020; 93(2): 76–84.

20. Barthold JS, Manson J, Regan V, et al. Reproductive hormone levels in infants with cryptorchidism during postnatal activation of the pituitary-testicular axis. J Urol 2004; 172(4 Pt 2): 1736–1741; discussion 1741.

21. Raivio T, Toppari J, Kaleva M, et al. Serum androgen bioactivity in cryptorchid and noncryptorchid boys during the postnatal reproductive hormone surge. J Clin Endocrinol Metab 2003; 88(6): 2597–2599.

22. Thorup J, Petersen BL, Kvist K, et al. Bilateral vanished testes diagnosed with a single blood sample showing very high gonadotropins (follicle-stimulating hormone and luteinizing hormone) and very low inhibin B. Scand J Urol Nephrol 2011; 45(6): 425–431.

23. Živković D, Fratrić I. Disturbances of Sperm Maturation and Minipuberty: Is There a Connection? Biomed Res Int 2014; 2014: 912746.

24. Quigley CA. The Postnatal Gonadotropin and Sex Steroid Surge – Insights from he Androgen Insensitivity Syndrome. J Clin Endocrinol Metab 2002; 87(1): 24–28.

25. Hadziselimovic F, Thommen L, Girard J, et al. The significance of postnatal gonadotropin surge for testicular development in normal and cryptorchid testes. J Urol 1986; 136(1 Pt 2): 274–276.

26. Andersson AM, Toppari J, Haavisto AM, et al. Longitudinal Reproductive Hormone Profiles in Infants: Peak of Inhibin B Levels in Infant Boys Exceeds Levels in Adult Men. J Clin Endocrinol Metab 1998; 83(2): 675–681.

27. Kiviranta P, Kuiri-Hänninen T, Saari A, et al. Transient Postnatal Gonadal Activation and Growth Velocity in Infancy. Pediatrics 2016; 138(1): e20153561.

28. Hadziselimovic F, Gegenschatz-Schmid K, Verkauskas G, et al. Gene Expression Changes Underlying Idiopathic Central Hypogonadism in Cryptorchidism with Defective Mini-Puberty. Sex Dev 2016; 10(3): 136–146.

29. Josso N, Cate RL, Picard JY, et al. Anti-Müllerian hormone: the Jost factor. Recent Prog Horm Res 1993; 48: 1–59.

30. Edelsztein NY, Grinspon RP, Schteingart HF, et al. Anti-Müllerian hormone as a marker of steroid and gonadotropin action in the testis of children and adolescents with disorders of the gonadal axis. Int J Pediatr Endocrinol 2016; 2016: 20.

31. Young J, Chanson P, Salenave S, et al. Testicular anti-mullerian hormone secretion is stimulated by recombinant human FSH in patients with congenital hypogonadotropic hypogonadism. J Clin Endocrinol Metab 2005; 90: 724–728.

32. Yamanaka J, Baker M, Metcalfe S, et al. Serum levels of Mullerian inhibiting substance in boys with cryptorchidism. J Pediatr Surg 1991; 26(5): 621–623.

33. Grinspon RP, Gottlieb S, Bedecarrás P, et al. Anti-Müllerian Hormone and Testicular Function in Prepubertal Boys With Cryptorchidism. Front Endocrinol (Lausanne) 2018; 9: 182.

34. Esposito S, Cofini M, Rigante D, et al. Inhibin B in healthy and cryptorchid boys, Ital J Pediatr 2018; 44(1): 81.

35. Suomi A-M, Main KM, Kaleva M, et al. Hormonal changes in 3-month-old cryptorchid boys. J Clin Endocrinol Metab 2006; 91(3): 953–958.

36. Christiansen P, Anderson AM, Skakkebæk NE, et al. Serum inhibin B, FSH, LH and testosterone levels before and after human chorionic gonadotropin stimulation in prepubertal boys with cryptorchidism. Eur J Endocrinol 2002; 147(1): 95–101.

37. Thorup J, Kvist K, Clasen-Linde E, et al. Serum inhibin B values in boys with unilateral vanished testis or unilateral cryptorchidism. J Urol 2015; 193(5): 1632–1636.

38. Andersson AM, Juul A, Petersen JH, et al. Serum Inhibin B in Healthy Pubertal and Adolescent Boys: Relation to Age, Stage of Puberty, and Follicle-Stimulating Hormone, Luteinizing Hormone, Testosterone, and Estradiol Levels. J Clin Endocrinol Metab 1997; 82(12): 3976–3981.

39. Thorup J, Clasen-Linde E, Thorup SC, et al. Pre-and postoperative status of gonadotropins (FSH and LH) and inhibin-B in relation to testicular histopathology at orchiopexy in infant boys with unilateral undescended testes. J Pediatr Urol 2015; 11(1): 25.e1–5.

40. Sansone A, Kliesch S, Isidori AM, et al. AMH and INSL3 in testicular and extragonadal pathophysiology: what do we know? Andrology 2019; 7(2): 131–138.

41. Cortes D. Cryptorchidism: aspects of pathogenesis, histology and treatment. Scand J Urol Nephrol 1998; 32(Suppl 196): 1.

42. Vincel B, Verkauskas G, Bilius V, et al. Gonadotropin-Releasing Hormone Agonist Corrects Defective Mini-Puberty in Boys with Cryptorchidism: A Prospective Randomized Study. Biomed Res Int 2018: 4651218.

43. Hutson JM, Thorup J, Beasley SW. Hormonal treatment. 2nd ed. In: Hutson JM, Thorup J, Beasley SW, editors. Descent of the Testis. Heidelberg, New York, Dordrecht, London: Springer International Publishing AG (2016): 149–156.

44. Wei Y, Wang Y, Tang X, et al. Efficacy and safety of human chorionic gonadotropin for treatment of cryptorchidism: A meta-analysis of randomised controlled trials. J Paediatr Child Health 2018; 54(8): 900–906.

45. Patel R, Kolon T, Huff D, et al. Testicular Microlithiasis and Antisperm Antibodies following Testicular Biopsy in Boys with Cryptorchidism. J Urol 2005; 174(5): 2008–2010; discussion 2010.

46. Radmayr C, Dogan HS, Hoebeke P, et al. Management of undescended testes: European Association of Urology/European Society for Paediatric Urology Guidelines. J Pediatr Urol 2017; 13(5): 550.

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