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Describe the proposed role of elevated maternal estrogen in the development of germ-cell tumors in men.
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Correct answer:
Elevated maternal estrogen can lead to decreased FSH production by negative feedback on the fetal pituitary system. Low levels of FSH lead to reduced Sertoli cell multiplication and lower levels of Müllerian-inhibiting substance (MIS). Low levels of MIS can hinder testicular descent as well as fetal gonocyte differentiation. Also, increased maternal estrogen can cause a decrease in local androgen production and inhibit testicular descent by negatively affecting Leydig cell function. Remember that maldescended testes seem to have a significant role in the development of germ-cell tumors.
