Editorial: Update on epidemiology, endocrinology and treatment of cryptorchidism
Bibliographic record
Abstract
Cryptorchidism is the most common birth defect in boys and requires surgical treatment in ca. one percent of boys. Increased risk of fertility problems and testicular cancer are the long-term worries following cryptorchidism. Frontiers of Endocrinology is publishing a series of articles summarizing the current knowledge on this condition and future research needs. We here sum up some of the main messages of the reviews and the original genetic study.Stine Holmboe et al. (1) reviewed the epidemiology of cryptorchidism and its potential risk factors, including endocrine disrupting chemicals. The incidence of cryptorchidism is 1-9% in term boys and cryptorchidism can also develop postnatally due to ascent of the testis. Our knowledge about the multifaceted etiology of congenital cryptorchidism has increased considerably over the last decades.Population studies have shown geographical and ethnic differences in the prevalence of cryptorchidism as well as a temporal increase. Maternal lifestyle, i.e. smoking and alcohol consumption during pregnancy, use of mild analgesics, gestational diabetes, or fetal factors, i.e. intrauterine growth retardation or low birth weight, increase the risk of cryptorchidism.The temporal increase of cryptorchidism prevalence, however, is thought to be related to external factors such as in utero exposure to endocrine disrupting chemicals (EDCs) from the environment.Evidence for this comes from observational ecological human studies, either performed as indirect exposure estimates from job matrices and geographic data or by longitudinal birth cohort studies measuring prenatal exposure to EDCs in maternal blood or urine, amniotic fluid, cord blood, placenta or breast milk in relation to birth outcome. EDCs comprise a very large number of nonpersistent chemicals, i.e. phthalates, bisphenols, parabens, or persistent chemicals, i.e. dioxins, polychlorinated and polyfluorinated compounds, pesticides, and human exposure is continuous to many of these. Human studies have been corroborated by animal experiments where EDC exposure is strictly controlled for dosage and timing, and which also allow exposure to chemical mixtures relevant for the human scenario.Genetic factors explain a small percentage of observed cases, often in familial cases or in cases related to more complex syndromes. Congenital defects in the Ras/MAPK genes cause RASopathies that underlie several syndromes. These include typical clinical features, one of which is often cryptorchidism. Juchnewitch et al. ( 2) combined data from Estonia, Australia, Canada, and the USA in their original article on RASopathies in undiagnosed infertile men. Cryptorchidism in these men was associated with variants of classical Noonan syndrome genes PTPN11, SOS1, SOS2, or LZTR1.As testis descend physiologically is first accomplished around gestational week 36, premature boys have a higher rate of undescended testes at birth which can spontaneously descend during the postnatal activation of the pituitary-gonadal axis. In addition, cryptorchidism is a risk factor for impaired spermatogenesis and subfertility as well as for testicular cancer in young adulthood.There is scientific evidence that early orchidopexy improves semen quality, whereas the benefit related to cancer risk is less clear. These expert reviews give an excellent insight to etiology, pathology, and treatment of cryptorchidism. It is obvious that much more research is needed to understand the reasons for maldescent and how to prevent germ cell damage and testicular cancer.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.012 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.006 | 0.008 |
| Insufficient payload (model declined to judge) | 0.015 | 0.009 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".