Testicular Dysgenesis Syndrome (TDS)

An increasingly common developmental disorder with environmental aspects, 2001


Numerous reports have recently focused on various aspects of adverse trends in male reproductive health, such as the rising incidence of testicular cancer; low and probably declining semen quality; high and possibly increasing frequencies of undescended testis and hypospadias; and an apparently growing demand for assisted reproduction.

Due to specialization in medicine and different ages at presentation of symptoms, reproductive problems used to be analysed separately by various professional groups, e.g. paediatric endocrinologists, urologists, andrologists and oncologists.

This article summarizes existing evidence supporting a new concept that poor semen quality, testis cancer, undescended testis and hypospadias are symptoms of one underlying entity, the testicular dysgenesis syndrome (TDS), which may be increasingly common due to adverse environmental influences.

Experimental and epidemiological studies suggest that TDS is a result of disruption of embryonal programming and gonadal development during fetal life. Therefore, we recommend that future epidemiological studies on trends in male reproductive health should not focus on one symptom only, but be more comprehensive and take all aspects of TDS into account. Otherwise, important biological information may be lost.

Evidence from animal studies and wildlife

There is a wealth of data showing that male animals exposed in utero or perinatally to exogenous oestrogens (diethylstilbo-estrol, ethinyl oestradiol, bisphenol A) and anti-androgens [flutamide, vinclozolin, 1,1-dichloro-2, 2-bis(p-chlorophenyl)ethylene (DDE), 1,1,1-trichloro-2, 2-bis(4-chlorophenyl)ethane(DDT)] develop hypospadias, undescended testis, low sperm counts or, in the worst case, intersex conditions, teratomas and Leydig cell tumours. A recent report provided experimental evidence that ubiquitous phthalates, can also hamper testicular descent in rats when administered prenatally.


  • Testicular dysgenesis syndrome: an increasingly common developmental disorder with environmental aspects, Endocrinology, Human reproduction (Oxford, England), NCBI PubMed, PMID: 11331648, 2001 May.

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