Cryptorchidism: seasonal variations in Greece do not support the theory of light

To examine seasonal trends of cryptorchidism in Greece, 583 males with true isolated cryptorchidism were analyzed. All 208 912 live-born boys born during the same period were used as a comparison group. Seasonality by month of birth was evaluated using both Edwards' model with adjusted frequencies and exact theta(i), and Walter-Elwood method with exact theta(i). Both tests resulted in consistent findings. The incidence of cryptorchid births in Greece follows a documented cyclic pattern of simple harmonic type with spring being the season of statistical predominance (peak in March with a second, almost equivalent, peak in May). In contrast, in autumn the incidence of cryptorchid births was considerably lower (trough in September). Given the fact that no significant differences in daylight length are found among seasons in Greece. the detection of a significant seasonal variation suggests that factors other than light are involved in the pathogenesis of cryptorchidsm. Low environmental temperature is proposed as a causative factor negatively influencing the maternal hCG profiles and the inguinoscrotal phase of testicular descent. This is further supported by: (i) the similarity of our results to those reported by other European countries of different longitude and geographical width and (ii) our data showing significantly smaller maternal hCG profiles at the 26th week of gestation during winter compared with summer. '...Whoever wishes to investigate medicine properly should proceed thus: In the first place to consider seasons of the year and what effect of them produces...' Hippocrates: Airs, Waters and Places.