Cryptorchidism: Impact of in Utero Exposure to Xenobiotics With Hormonal Action
Cryptorchidism: Impact of in Utero Exposure to Xenobiotics With Hormonal Action
We studied prospectively the incidence of cryptorchidism in Nice area. We tightly matched
 each affected child (n=95) with 2 healthy controls (n=188) and assessed risk factors for
 cryptorchidism focussing on prenatal exposure (cord blood and maternal milk) to endocrine
 disruptors known to affect testis migration, searching for correlations with cryptorchid
 status
Since fetal exposure to anti-androgenic and/or estrogenic compounds is deleterious to animal
 reproduction, such exposure could be harmful to human fetus as well. Data are scarce on human
 exposure and the occurrence of cryptorchidism.

 DESIGN: From 2002 to 2005, we performed a prospective case-control study to assess the
 incidence of cryptorchidism and fetal exposure to selected chemicals in newborn boys in Nice
 area. This study was approved by the ethical board of our institution. Out of 6246 live
 births at or after 34 weeks of gestational age and born at 2 maternity wards (University
 hospital of Nice and General Hospital of Grasse), 102 boys were diagnosed with
 cryptorchidism. After informed parental consent, 95 were included in this study, along with
 188 tightly matched controls. Cord blood was collected at birth, as well as maternal milk
 from nursing mothers. Lifestyle and job questionnaires were filled by parents. Children were
 re-examined at 3 and 12 months of age to assess possible secondary testis migration, or
 confirm their control status.

 151 cord bloods (67 cryptorchid, 84 controls) and 125 maternal milks (56 for cryptorchid boys
 and 69 for controls) were collected and screened for xenobiotics, including DDE, PCBs, and
 dibutylphthalate (and metabolite monobutylphthalate -mBP). We established scores of exposure
 in colostrum and studied possible relationships between exposure and cryptorchidism. We also
 measured hormonal status on cord blood including AMH and inhibin concentrations.

 RESULTS: The incidence of cryptorchidism was 1.6% at birth, similar in Nice and Grasse, and
 0.8% at 3 months of age. Xenobiotic measurements in cord blood and milk showed universal
 exposure in our population. Median concentrations in maternal milk were higher though not
 significantly in cryptorchid vs controls: DDE 119.4 vs 80 ng/g of fat, ΣPCB 206.3 vs 166.8
 ng/g of fat, mBP 17.3 vs 10.3 ng/g of milk. Cryptorchid boys were more likely to be
 classified in the most contaminated groups for ΣPCBs (57.1% vs 39.1% p=0.045), DDE (53.6 vs
 36.2% p=0.037) and to a lesser degree mBP (58.1 vs 40%, p=0.13). This was also true for the
 composite score using DDE and ΣPCBs (30.4 vs 21.7%, p=0.05). Last, the odds ratio for
 cryptorchidism at birth was increased for the highest score of: DDE: 2.03 (p=0.05, 95%CI
 0.99-4.17); ΣPCB 2.07 (p=0.046, 95%CI 1.01-4.25); composite score without phthalates 2.41
 (p=0.06, 95%CI 0.96-6.1) vs the lowest score of those components.

 CONCLUSIONS: The incidence of cryptorchidism at birth of 1.6% is similar to other
 populations. Our results support an association between fetal exposure to DDE, PCBs and
 possibly mBP, and the occurrence of cryptorchidism at birth. Higher concentrations in milk
 could be a marker of higher exposure or for an impaired detoxification pattern in genetically
 predisposed individuals. Long term follow up of our cohort is planned to screen cryptorchid
 and control boys for low sperm count, infertility and testis cancer.
Inclusion Criteria:

 -  Women having given birth to a boy at University hospital of Nice or Général hospital
 of Grasse

 Exclusion Criteria:

 -  parents who don't signed consent