Fertility and Cryptorchidism-Reply

In Reply .—Dr Hadziselimovic and our group are in complete agreement that all children with cryptorchidism should have treatment. All of the patients we reported in our article, which demonstrated that fertility prospects for children with cryptorchidism are better than popularly believed, had been treated by surgery, hormone therapy, or both. One of our principal achievements was to demonstrate that presurgical treatment with hormones, or even postsurgical hormone treatment, appeared to do no harm to the fertility, which certainly agrees with Dr Hadziselimovic's statements. However, we see no justification for his statement that "it is well known that (1) the more pathologic the unilateral cryptorchid gonad appears, the more damaged is the contralateral descended one; and (2) there is a proven involvement of the hypothalamic-pituitary-gonadal axis in both unilateral as well as bilateral cryptorchidism, with different degrees of expressivity." In fact, a mechanical defect was obvious in many of our