An undescended testicle, medically known as cryptorchidism, occurs when one or both testicles fail to descend into the scrotum. This common congenital condition affects male infants and can impact male fertility. This article explores the connection between undescended testicles and male infertility, detailing its causes, effects, and treatment.
Understanding Undescended Testicles
Testicles normally form in the abdomen during fetal development. They descend into the scrotum during the third trimester of pregnancy, usually before birth or within the first few months of life. Approximately 1-2% of full-term male infants are affected by this condition.
The descent of the testicles into the scrotum is important for spermatogenesis, the process of sperm production. The scrotum maintains a temperature that is approximately 2-4°C cooler than the core body temperature. This cooler environment is necessary for the healthy development and function of sperm.
How Undescended Testicles Affect Fertility
Undescended testicles can impair fertility primarily due to the higher temperature inside the body. Testicles remaining in the warmer abdominal or inguinal regions experience conditions that are not optimal for sperm production. This elevated temperature can damage germ cells, which are precursors to sperm, leading to impaired spermatogenesis.
Damage to these germ cells can result in reduced sperm count, decreased sperm motility (movement), and abnormal sperm morphology (shape). The primary impact is on sperm-producing cells. The degree of fertility impairment varies depending on whether one or both testicles are affected; bilateral cryptorchidism carries a higher risk of infertility compared to unilateral cases.
Diagnosis and Treatment
Undescended testicles are diagnosed during physical examinations conducted during infant check-ups. A healthcare provider will palpate the scrotum to determine if the testicles are present. Some undescended testicles are palpable, while others are non-palpable, possibly located in the abdomen or even absent.
The primary treatment for an undescended testicle is surgical correction, known as orchiopexy. This procedure involves bringing the testicle down into the scrotum and securing it in place to ensure it resides in the cooler environment. The timing of this surgery is important, with recommendations suggesting it be performed between 6 and 12 months of age. Early intervention aims to minimize long-term damage to the sperm-producing cells.
Fertility Outlook After Treatment
While surgical correction significantly improves the chances of future fertility, it does not guarantee normal fertility for all individuals. About 10% of males who undergo surgical correction for undescended testicles may experience reduced fertility later in life. Several factors influence the fertility outlook following treatment.
The number of affected testicles plays a role, as individuals with bilateral cryptorchidism face a greater risk of subfertility even after successful surgery compared to those with unilateral cryptorchidism. The age at which surgery is performed also impacts the outcome, with earlier intervention leading to better fertility potential. The original position of the testicle can also influence the degree of potential damage. Many individuals go on to have children, though some may require assisted reproductive techniques.