Birth defect in boys linked to cancer and infertility

A large study in Australia has found a link between undescended testes at birth and development of testicular cancer and infertility in later life. 

Health data from 350,835 men in Australia born between 1970 and 1999 suggested that those born with undescended testes had a 2.4 times higher risk of developing testicular cancer. They also had a 21 percent lower chance of becoming a father than unaffected men, and twice the likelihood of seeking fertility treatment. 

'Before this study, there was no evidence-based information on the impact of early surgery on the future risk of testicular cancer and infertility in adult males,' said Dr Francisco Schneuer of the University of Sydney, an author of the study. 'Early diagnosis, ongoing examination and monitoring by parents and health practitioners and timely referral to surgery of boys with undescended testes is important to ensure adherence with guidelines.'

Around 1 in 100 boys are born with either one or both testes undescended, making it the most common congenital condition affecting male genitalia. The condition is treated with a surgery known as orchidopexy, which involves moving testes into the scrotum. 

The study demonstrated that delaying the surgery increased the risk of the conditions associated with undescended testes. With every added 6-month delay before surgery, there was a 6 percent increase in risk of testicular cancer, a 1 percent reduction in likelihood of paternity and a 5 percent increase in likelihood of seeking fertility treatment.

International guidelines recommend that orchidopexy be performed before 18 months. However, compliance is poor. In Australia, around half of surgeries are performed after this time. Worldwide more than three-quarters of surgeries are carried out after the recommended 18-month cut-off. 

The authors said the study underlined the benefits of carrying out orchidopexy sooner rather than later. 

'Early surgery can reduce the risk of malignancy and male infertility, and ultimately has the potential to reduce future adult male reproductive disorders,' said Dr Schneuer.