Testicular descent

In prepubertal boys with undescended gonads, hCG can be used to distinguish a truly retained (cryptorchid) testis from a retracted (pseudocryptorchid) one. Testicular descent during a course of hCG administration usually foretells permanent testicular descent at puberty, when circulating LH levels rise. Lack of descent usually means that orchiopexy will be necessary to preserve spermatogenesis. 

Toppari J, Virtanen H, Skakkebaek NE, Main KM. Environmental effects on hormonal regulation of testicular descent. J Steroid Biochem Mol Biol 2006 102(1 5) 184 6. 

This medication is a hormone which stimulates the ovaries and the testes. It is used in males to stimulate testicular descent or testicular growth and development. In females, this medication is used in combination with other medication to induce ovulation. Females may require only one dose a week. Males may receive a series of injections 2 to 3 times a week. HCG helps "kick-start" your natural production of hormone / testosterone into operation. Normally the dosage and schedule goes like this 1500iu on Monday and Thursday. 

CRYPTORCHIDISM Cryptorchidism, the failure of one or both testes to descend into the scrotum, affects up to 3% of fuU-term male infants, becoming less prevalent with advancing postnatal age. Cryptorchid testes have defective spermatogenesis and are at increased risk for developing germ cell tumors. Hence, the current approach is to reposition the testes as early as possible, typically at 1 year of age but definitely before 2 years of age. The local actions of androgens stimulate descent of the testes thus, hCG can be used to induce testicular descent if the cryptorchidism is not secondary to anatomical blockage. Therapy usually consists of injections of hCG (3000 lU/m body surface area) intramuscularly every other day for 6 doses. 

Like LH, hCG stimulates the production of testosterone by the testes therefore, it is used in treating male hypogonadism and prepubertal cryptorchidism in young males (age, 4-9 years), in whom it stimulates testicular descent. In treating infertility caused by pituitary dysfunction, hCG, in combination with menotropins (as discussed previously) or clomiphene, can induce ovulation and pregnancy in anovulatory females. This hCG, which is of natural origin, is purified from the urine of pregnant women. 

Teratogenicity In 47 400 male infants registered in the Danish National Birth Cohort (1996-2002) maternal exposure to paracetamol for more than 4 weeks during gestational weeks 8-14 (the proposed time-window for programming testicular descent) was associated with a hazard ratio of 1.38 (95% CI=1.05,1.83) for cryptorchidism [21. ... 

Some phthalates, such as DEHP, are endocrine dismptors that affect the developing male reproductive system by interrupting the production of fetal testosterone and the protein involved in testicular descent, insuUn-Uke 3 (insl3), while other phthalates, such as DEP, are not endocrine dismptors. 

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