***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In a modified , double‐blind controlled study , 163 prepubertal boys ( aged 1.8–13.0 years ) with bilateral and 94 ( aged 1.5–13.1 years ) with unilateral cryptorchidism were allocated to treatment with either human chorionic gonadotropin ( i m ) , gonadotrophin releasing hormone ( intranasally ) or placebo ( intranasally ) . In individuals with the bilateral condition treatment with human chorionic gonadotrophin result ed in complete descent of both testes in 23 % of patients . Treatment with human chorionic gonadotrophin in unilateral cryptorchidism result ed in complete descent in 19 % of patients ; all results were significantly better than those obtained with gonadotrophin releasing hormone or placebo . Linear and logistic regression analysis of the results obtained by treatment of bilateral disease showed that all treatments were more successful the younger the age of the boys . The data indicated that bilateral and unilateral cryptorchidism respond differently to hormonal treatment . We suggest that human chorionic gonadotrophin should be the first choice of treatment for prepubertal boys older than one year The effects of hormonal treatment ( LH-RH , LH-RH plus hCG ) on undescended testis were studied on 42 testicles in 37 boys under 3 years of age .  Descensus was achieved primarily in 40 % but eight testicles reascended . A new course of hCG result ed in descensus in three cases . Altogether , therefore , full descensus could be achieved in 29 % of cases with hormonal treatment . Hormonal treatment is recommended before surgery This r and omized double-blind placebo-controlled study was initiated to analyze the behavior of epididymis , processus vaginalis and testicular descent in cryptorchid boys treated with a low dose ( 20 μg ) of a  luteinizing hormone-releasing hormone analogue ( Buserelin ) , administered daily , as a nasal spray , for a short period ( 28 days ) . Fifty-nine true cryptorchid boys were r and omly assigned to 3 groups : buserelin , treatment [ 22 ] , surgical treatment [ 18 ] or placebo control group [ 19 ] . The 3 groups of patients were similar before treatment in regard to testicular position , chronological and bone age , height and weight , luteinizing hormone , follicle-stimulating hormone , testosterone , penile size and the volume of the contralateral descended testis . None of the patients had retractile testes . Buserelin significantly induced testicular descent compared to the boys treated with a placebo ( P<0.01 ) . A normal epididymis was found more often in boys with successful descent ( P<0.003 ) . A closed processus vaginalis was also more frequently observed in the group treated with buserelin than in surgically treated one ( P<0.05 ) . In conclusion , buserelin was capable of inducing testicular descent besides provoking further development of the epididymis and closing the processus vaginalis Fifty unilaterally cryptorchid boys aged 3 to 8 years were r and omly and blindly allocated to treatment with luteinizing hormone releasing hormone or placebo intranasally . In the treated group , no significant descent of the undescended testis was found , whereas a minor downward movement of the scrotal testis occurred ( P less than 0.001 ) , probably as a result of decreased retraction by the cremaster muscle . Basal serum testosterone concentrations and testicular volume increased after treatment ( P less than 0.01 and P less than 0.001 , respectively ) . The response to an acute LHRH test , 100 micrograms/m2 body surface IV , before and after treatment , showed an increase in the luteinizing hormone peak value and a decrease in the follicle-stimulating hormone response in a significant number of patients ( P less than 0.001 ) . In the individual patient , there was a positive correlation between the increase in basal serum testosterone concentration and the degree of downward movement of the undescended testis ( P less than 0.05 ) In a double‐blind placebo‐controlled study in 49 boys with cryptorchidism the effect of intranasal synthetic LHRH was studied . After 8 weeks improvement in testicular location was found in 13 testes ( 37 % ) , but this improvement was considered sufficient of only six testes . Placebo result ed in an improved location in 18 % of the testes . The mean change in testicular position ( expressed in cm ) after LHRH therapy was slightly greater than after placebo but only in the squatting position did this difference reach significance . Aggressive behaviour was reported in 23 % of the children treated with LHRH . A second LHRH course did not result in significant improvement in any of the patients . At follow‐up reascent was frequently seen . The final results in unilateral cryptorchidism are poorer than those in bilateral cryptorchidism . LHRH therapy leads to higher plasma LH levels and a lower FSH in response to an intravenous LHRH test . In 15 boys plasma testosterone levels rose above 0.4 nmol/1 . We conclude that intranasal LHRH application has a limited value for the treatment of cryptorchidism but may be suitable as a diagnostic test The effect of intranasal luteinising-hormone releasing hormone ( L.H.R.H. ) in 84 boys with unilateral or bilateral cryptorchidism was evaluated in a double-blind controlled trial . Boys with retractile testes were not studied . L.H.R.H. caused no side-effects ; plasma antibodies to L.H.R.H. were never demonstrated . Four weeks ' therapy with intranasal L.H.R.H. administered in six doses daily ( 1.2 mg/day ) led to complete descent in 38 % of a total of 61 testes , an improved position in 28 % , and no response in 19 % ; 15 % of testes were never palpated . After placebo the position of 25 % of testes was improved ; there was no response in 75 % of a total of 51 testes . The success-rate seemed to be independent of age , but was related to the initial testicular position , with complete descent in only 11 % of testes not previously palpated compared with 48 % of testes found in the inguinal region We have conducted a modified double-blind study on the effect of human chorionic gonadotropin ( hCG ) , gonadotropin releasing hormone ( GnRH ) and placebo on bilateral and unilateral maldescended testes . One hundred and fifty-five boys with bilateral and 88 boys with unilateral cryptorchidism fulfilled the inclusion criteria and completed the treatment protocol . The boys were between 1 and 13 years of age .  hCG was administered as intramuscular injections twice weekly for 3 weeks . GnRH and placebo were given intranasally . hCG was superior to GnRH and placebo in the treatment of bilateral maldescended testes ( p = 0.0009 ) . Both testes descended in 25 % of the boys following treatment with hCG , and improvement in the position of the testes was obtained in a further 25 % of the cases . hCG administration result ed in complete testicular descent in 14 % of boys with unilateral cryptorchidism compared with 3 and 0 % after placebo and GnRH , respectively ( p = 0.07 ) . The testis had moved to a more distal position in 46 % of the boys treated with hCG . There was no significant difference between the treatment groups with regard to age or initial position of the testes . We conclude that a success rate of 25 % justifies the use of hCG in the treatment of maldescended testes , whereas the study did not support a general use of GnRH administered intranasally In a double-blind , placebo-controlled multicentre study , the effect of luteinizing-hormone-releasing-hormone ( LHRH ) in 141 boys was analysed after 4-week treatment period with 0.4 mg LHRH nasal spray or placebo nasal spray three times daily . Data from 123 boys was analysed , with 62 boys in the treatment group and 61 in the  placebo group . Full response i.e. the testis at the bottom of the scrotum on both sides in boys with bilaterally undescended testes  , was found in six patients , one of them in the placebo group [ Therapeutic gain of LHRH with 95 % CI : 8.1 % ( 0.1 - 16.6 % , P = 0.12 ) ] . Only in these boys could surgery be avoided . Considering the number of testes ( and not the number of boys ) a significant effect was found on at least one testis in 25 % of boys with bilaterally undescended testes [ Therapeutic gain with 95 % CI : 24.0 % ( 13.2 - 34.8 % , P = 0.001 ) ] . In unilateral undescended testes , the LHRH treatment showed no effect ( P = 1.00 ) . The inclusion of retractile testes did not affect our results . In our opinion LHRH has a limited place in treatment of the non-descended testis We conducted a r and omized , double-blind study comparing intranasal gonadotropin-releasing hormone ( 1.2 mg per day for 28 days ) with parenteral human chorionic gonadotropin ( 3300 IU per week for four weeks ) in the treatment of cryptorchidism in 33 boys one to five years old ( 29 with unilateral and 4 with bilateral cryptorchidism ) .  Testicular descent into the scrotum occurred in 3 of the 16 patients ( 19 percent ) treated with gonadotropin-releasing hormone and in 1 of the 17 ( 6 percent ) treated with human chorionic gonadotropin ( P = 0.23 ) . The mean luteinizing hormone and testosterone levels were similar in both groups before treatment . During treatment , the testosterone levels were significantly increased in both groups , but higher levels occurred in the group treated with human chorionic gonadotropin ( P less than 0.05 ) . In a parallel ( but uncontrolled ) study of five boys with retractile testes ( defined as a nonscrotal testis that could be manipulated into the bottom of the scrotum ) who were originally excluded from the main protocol but were treated with the same regimen of human chorionic gonadotropin  , descent into the scrotum occurred in all patients . We conclude that hormonal therapy with either gonadotropin-releasing hormone or human chorionic gonadotropin is , in most cases , ineffective in promoting testicular descent of true cryptorchid testes . However , short-term treatment with human chorionic gonadotropin is very effective in producing descent of retractile testes . These results suggest that the wide discrepancies in apparent efficacy in previous trials of hormonal therapy of cryptorchidism may have been due to inclusion in those studies of various proportions of patients with retractile testes Synthetic LHRH ( HOE 471 ) administered intranasally over a period of 4 weeks for treatment of uni‐ or bilateral cryptorchidism in nineteen otherwise healthy prepubertal boys led to increased basal and peak LH values and to markedly decreased peak FSH values in the i.v . LHRH test . Basal testosterone remained unchanged . Sixteen cryptorchid boys treated with placebo served as a control group . The reduced FSH response to i.v . LHRH could be due to induction of a gonadal feedback mechanism rather than pituitary depletion of FSH , in view of the favourable therapeutic effect and the increased LH secretion seen in some of our patients . Pretreatment LHRH tests were available in twenty successfully and in twenty‐eight unsuccessfully treated boys . LH values were similar in both groups , whereas FSH peak values were significantly higher in boys who responded successfully to subsequent therapy . Testicular descent occurred most readily in boys with a large pool of easily releasable FSH and without a significant rise in testosterone ( in contrast to HCG treatment ) . We suggest that FSH induces changes that potentiate the local action of testosterone A r and omized study of two protocol s of human chorionic gonadotropin ( hCG ) treatment was performed in 183 prepubertal boys between 7 months and 12 years of age : protocol I , in which the boys were given 7 injections of 1,500 IU every other day , and protocol II consisting of 4 injections of 100 IU/kg at 4- to 5-day intervals . In both protocol s , by the end of the test , testosterone had risen significantly to values within the normal adult male range . However , the amplitude of the rise was slightly but significantly lower using protocol II ( 4.08 + /- 2.07 ng/ml ) than protocol I ( 5.16 + /- 2.73 ng/ml ) . It would thus appear that repetition of the hCG injection at intervals of less than 4 days is unnecessary , and that a total stimulation period of 2 - 3 weeks is sufficient . Although not correlated with testosterone levels , the success rates for treatment were similar in both protocol s and comparable to rates reported in the literature 
    Output:
    
With the information analyzed until the present , the evidence for the use of hCG vs. GnRH shows advantages for hCG , and this review also shows that there is evidence that luteinizing hormone releasing hormone ( LHRH ) is more effective than placebo .
But because this evidence is based on few trials , with small sample sizes and moderated risk of bias , this treatment can not be recommended for everyone , and there is no evidence that supports hCG ’s use in larger doses and larger intervals .