An undescended testicle, or cryptorchidism, occurs when one or both testicles do not move into the scrotum before birth.
This condition can sometimes affect sperm production and future fertility, especially when both testicles are undescended.
However, it does not always cause infertility. Early diagnosis and treatment can help protect testicular health and fertility potential.
Before birth, the testicles normally move from the abdomen down into the scrotum. Sometimes, one or both testicles do not move down properly. This is called an undescended testicle, or cryptorchidism.
An undescended testicle may stay in the abdomen or groin instead of reaching the scrotum. It can affect one testicle (unilateral) or both testicles (bilateral).
In some babies, the testicle moves into the scrotum naturally during the first few months. If it does not, a doctor should check it and recommend the right treatment.
Undescended testicles are fairly common in newborn boys and are more common in babies born prematurely. Many testicles that are undescended at birth move into the scrotum naturally during the first few months.
A few simple points help explain what usually happens:
Early evaluation is important because prolonged cryptorchidism can affect testicular development, future fertility, and long-term health.
The scrotum provides a cooler environment than the abdomen or groin, which is important for normal sperm development.
When a testicle remains in a warmer location for a long period, the cells involved in sperm production may be affected.
Over time, an undescended testicle may be associated with:
The effect can be more significant when both testicles are undescended.
Research summarized in the AUA guideline shows substantially lower fertility and paternity rates among men with a history of bilateral cryptorchidism compared with those who had unilateral cryptorchidism.
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No. Having an undescended testicle does not mean a man will definitely be infertile.
Men with one undescended testicle can often have normal fertility, particularly when the other testicle is healthy.
The AUA guideline reports that men with previous unilateral cryptorchidism have generally had much better paternity outcomes than men with bilateral cryptorchidism.
However, fertility can still vary from person to person. The condition itself, the health of the descended testicle, treatment timing, and other reproductive factors can all play a role.
Several factors can influence the risk of future infertility problems.
Bilateral undescended testicles generally carry a greater fertility risk than a unilateral condition because sperm production may be affected on both sides.
The longer a testicle remains outside the scrotum, the longer it is exposed to an environment that is less suitable for normal testicular development. Early treatment is therefore recommended.
A testicle located higher in the abdomen may have different implications from one that is closer to the scrotum. However, location alone does not determine a person’s future fertility.
Some children with cryptorchidism may have underlying differences in testicular development that can affect sperm-producing cells independently of the testicle’s position.
Fertility is not the only concern. An undescended testicle can also increase the risk of testicular cancer. Moving the testicle into the scrotum may make examination and monitoring easier.
But surgery does not completely remove the increased cancer risk associated with previous cryptorchidism.
Other possible complications include:
This is why an undescended testicle should not simply be left unmonitored.
Diagnosis usually begins with a physical examination. A doctor checks whether the testicle can be felt in the scrotum or along its expected path of descent.
In many infants and children, imaging is not necessary when the testicle can be assessed clinically. Ultrasound or other imaging may sometimes be considered in specific situations, but these tests are not routinely required for every undescended testicle.
If the testicle cannot be located, particularly when both testicles are absent from the scrotum, additional evaluation may be needed.
If an undescended testicle does not move into the scrotum on its own, treatment may be needed. The main treatment is orchiopexy. During this surgery, the doctor moves the testicle into the scrotum and secures it in place.
Treatment is usually done in early childhood. Treating the condition early can help support normal testicular development and may reduce the risk of future fertility problems.
There are several important points to understand about treatment:
The right treatment depends on the child’s age, the location of the testicle, and whether one or both testicles are affected.
Yes, early treatment may help protect future fertility in boys with an undescended testicle.
Orchiopexy moves the testicle into the scrotum, where it can develop in a more suitable environment and be checked more easily as the child grows.
The effect on fertility can vary depending on whether one or both testicles are affected. Some important factors include:
For this reason, early diagnosis and appropriate treatment are important steps in protecting future reproductive health.
Some men have an undescended testicle that was not treated during childhood. Others may have had treatment as children but later have concerns about fertility.
A gynaecologist or male fertility specialist clinic can check testicular health with a physical exam, hormone tests, and a semen analysis. These tests can show whether sperm production may be affected.
The risk can vary from person to person:
Having an undescended testicle does not automatically mean infertility. If there are fertility concerns, a specialist can recommend the right tests and treatment options.
If you or your child has an undescended testicle, a urologist or pediatric urologist can explain the available treatment and follow-up options.
