When it comes to male reproductive health, undescended testicles are a concern that often goes unnoticed until it becomes a problem. Undescended testicles, also known as cryptorchidism, occur when one or both testicles fail to descend into the scrotum during fetal development. This condition affects roughly 1 in 100 newborn boys, making it a relatively common concern. However, what many people don’t realize is that undescended testicles can have significant implications for male fertility.
Testicles that don’t descend into the scrotum won’t work normally. Testicles sit in the scrotum, to be at slightly lower than body temperature in order to keep sperm healthy. While the testicles are in the abdomen, they are warmer than they should be. If they are at a higher temperature for too long, the sperm will not mature well. This can lead to infertility. This is a greater risk when both testicles remain within the abdomen.
There are two main types of undescended testicles:
– **Unilateral:** Only one testicle fails to descend.
– **Bilateral:** Both testicles remain undescended.
Undescended testicles are also linked to a higher risk of:
- Testicular cancer in adulthood
- Testicular torsion (twisting of the blood vessels that bring blood to and from the testis)
- Inguinal hernia (a hernia that develops near the groin)
In about half of the boys born this way, the testicle will descend into place on its own. This often happens within the first 3-6 months of life. If they don’t descend after 6 months, they should see a pediatric urologist and treatment may be needed.
Diagnosing undescended testicles is typically straightforward and can often be done shortly after birth or during a routine check-up. A pediatrician or urologist will physically examine the baby’s scrotum and may use ultrasound imaging to confirm the diagnosis. In some cases, the testicles may spontaneously descend within the first few months of life. However, if they don’t, treatment may be necessary.
Effects on Male Fertility
Undescended testicles can have several consequences for male fertility, including:
- **Impaired Spermatogenesis:** The temperature inside the scrotum is lower than that within the abdominal cavity, creating an optimal environment for sperm production (spermatogenesis). When testicles remain undescended, they are exposed to higher temperatures, which can impair sperm production.
- **Reduced Sperm Quality:** Even if sperm production occurs, the quality of sperm may be compromised. Sperm from undescended testicles may have abnormalities, making it more challenging for them to fertilize an egg.
- **Increased Risk of Infertility:** Men with a history of undescended testicles have a higher risk of infertility compared to those without the condition. This increased risk can persist into adulthood.
The main goal of treating undescended testicles is to bring the testicles into the scrotum to improve fertility and reduce the risk of other complications. Treatment options include:
- **Hormone Therapy:** In some cases, hormone therapy may be prescribed to stimulate testicular descent. However, this is typically less effective in older children and adults.
- **Surgery (Orchiopexy):** Orchiopexy is a surgical procedure that involves moving the undescended testicle(s) into the scrotum and securing them in place. This is the most common and effective treatment, especially when performed in early childhood.
Undescended testicles are not only a cosmetic concern but also a potential threat to male fertility. Timely diagnosis and appropriate treatment, often in the form of surgery, can help mitigate these risks and improve the chances of achieving a healthy pregnancy.