Undescended Testicle (Cryptorchidism) and Fertility: What Men With This History Should Know

Some men carry a piece of medical history that they barely remember: a testicle that had not come down into the scrotum in childhood. It may have been treated with surgery when they were young, or it may never have been noticed at all. Years later, when a couple struggles to conceive, that history can suddenly matter.

This is a topic many men find uncomfortable and private. This guide explains what an undescended testicle is, how it can relate to fertility, which tests help and what options exist. It is written to be factual and respectful, and it does not replace a doctor's examination.

The Short Answer

What to Know An undescended testicle in childhood can affect sperm production later in life, even if it was treated, but many men with this history still father children. The effect depends on whether one or both sides were affected, when it was treated and how the testicles function now. A semen analysis and an examination by a urologist or andrologist give the clearest picture.

मराठीत थोडक्यात: लहानपणी अंडकोष खाली न उतरल्यास पुढे शुक्राणूंच्या निर्मितीवर परिणाम होऊ शकतो, उपचारानंतरही. तरीही अनेक पुरुष पिता होतात. परिणाम एका की दोन्ही बाजूंवर, उपचार कधी झाले आणि आता कार्य कसे आहे यावर अवलंबून असतो. वीर्य तपासणी आणि तज्ज्ञांची तपासणी स्पष्ट चित्र देते.

हिंदी में संक्षेप: बचपन में अंडकोष नीचे न उतरने का असर बाद में शुक्राणु बनने पर पड़ सकता है, इलाज के बाद भी। फिर भी कई पुरुष पिता बनते हैं। असर एक या दोनों तरफ, इलाज कब हुआ और अभी कार्य कैसा है, इस पर निर्भर करता है। वीर्य जांच और विशेषज्ञ की जांच साफ तस्वीर देती है।

What an Undescended Testicle Is

Before birth, the testicles develop inside the abdomen and normally move down into the scrotum. In some boys, one or both testicles do not complete this journey. The medical term is cryptorchidism.

Sometimes a testicle comes down by itself in early life. In other cases, doctors advise a small surgery, called orchiopexy, to bring it down and fix it in place. Some men are never treated, especially if the problem was missed or the family did not have access to care.

Why Position Matters for Sperm

Sperm production works best at a temperature slightly lower than the body's core, which is why the testicles sit outside the body. A testicle that stays in a warmer position for a long time may not develop or work as well as one that is in the scrotum.

This is why a history of an undescended testicle is relevant for fertility. The effect is not the same for everyone, and it depends on many factors. Many men with this history have normal sperm, and some do not.

One Side or Both Sides

If only one testicle was affected, the other testicle often compensates, and many men with this history can father children naturally. If both were affected, the chance of reduced sperm production is higher, and some men may have very low or no sperm in the semen.

Timing also matters. Treatment earlier in childhood is generally considered better for later function than treatment later, but this varies, and your doctor can interpret your own history. If you have no records, please do not worry: an examination and semen analysis can still tell a lot.

What Tests May Be Suggested

If you have this history and are concerned about fertility, a urologist or andrologist may suggest some of the following.

• A physical examination — to check position, size and feel of the testicles.
• Semen analysis — the key test for sperm. See semen analysis report explained.
• Hormone tests — to check how the testicles and the brain are communicating.
• A scrotal ultrasound — sometimes used to look at the testicles and surrounding structures.
• Genetic tests — occasionally advised, depending on the results. See Klinefelter syndrome and fertility.

Please avoid judging a single report in isolation. Semen results can vary between samples, so doctors often repeat the test. For how accurate these tests can be, read how accurate are male fertility tests.

If Sperm Are Present

If your semen analysis shows sperm, even in low numbers, there may be several paths. Your doctor may discuss lifestyle steps, treatment of any other issues and options such as IUI or IVF with ICSI, depending on the results and your partner's tests.

A low count does not mean it is impossible to conceive. For an overview, see low sperm count: signs, causes and treatment and ICSI vs standard IVF.

If No Sperm Are Seen

If a semen analysis shows no sperm, it is called azoospermia, and this is more likely when both testicles were affected. It is not always final, because sperm can sometimes still be found in the testicle through a procedure. Your doctor can explain the options.

Please read azoospermia explained and TESA/TESE explained for more detail, and take time to absorb this news before making any decision. A counsellor can also help. Our guide on infertility and mental health may be useful.

Other Health Points to Know

Men with a history of an undescended testicle may be advised to have regular self-examination and follow-up, since this history can be linked with a higher chance of certain testicular conditions. This is a reason to see a doctor, not a reason to panic. Please ask your doctor what check-ups make sense for you.

Other childhood or adult issues can also affect male fertility, such as past infection, injury or other conditions. Our guides on varicocele and fertility and male infertility and genital infections cover related areas.

Talking About It

Many men feel shame or embarrassment about this history, particularly if they have never discussed it with anyone. Some have kept it quiet even from their partner. Please know that this is a medical condition and not a reflection of your masculinity.

Sharing the history with your partner and your doctor is a step towards answers. Fertility involves two people, and the load should be shared. For help starting the conversation, see for the men: a guide to supporting your partner through IVF and male infertility: symptoms most men ignore.

Questions to Ask Your Doctor

• How does my history affect my fertility?
• What do my examination and semen analysis show?
• Which further tests do you advise, and why?
• What are the options if the count is low or if no sperm are seen?
• Do I need follow-up checks for my testicles in general?
• What can my partner and I do now, and how soon?

Common Myths About Undescended Testicle and Fertility

• Myth: "If it was fixed in childhood, fertility is always normal." — Surgery helps, but sperm production can still be affected. A semen analysis tells you more.
• Myth: "A man with one testicle cannot have children." — Many men with one testicle father children naturally.
• Myth: "This history means you are less of a man." — It is a medical condition, and it says nothing about your worth.
• Myth: "Nothing can be done if sperm count is low." — Several options exist, depending on your results. Your doctor can explain them.
• Myth: "A herbal tonic can make the testicle work normally." — No such product is reliably proven. Please speak with your doctor, and never start or stop a medicine on your own.

When to See a Doctor

If you have a history of an undescended testicle, even if it was treated, and you are planning a pregnancy, it is reasonable to see a urologist or andrologist and have a semen analysis. Do not wait for a year of trying if you have this history.

See a doctor promptly if you notice a lump, swelling, pain or a change in size in a testicle. You can also speak with one of our specialists about your reports and your partner's plan.

Frequently Asked Questions

Can a man with an undescended testicle father a child?

Many do, especially if only one side was affected. A semen analysis and examination give the clearest picture.

Does surgery in childhood restore fertility?

Surgery helps, but it does not guarantee normal sperm production. Your doctor can interpret your own situation.

Can a man with one testicle have children?

Often yes, because the other testicle can compensate. Testing can confirm your sperm health.

What if I have no records of my childhood treatment?

An examination and semen analysis can still tell a lot. Share what you remember with your doctor.

What if there is no sperm in the semen?

This is called azoospermia. Sperm can sometimes still be found in the testicle through a procedure, and your doctor can explain the options.

Does this history increase any health risks?

It can be linked with a higher chance of certain testicular conditions. Ask your doctor about check-ups.

Should I tell my partner?

Fertility involves both of you, and sharing the history helps you plan together. A doctor or counsellor can support the conversation.

When should I get tested?

If you have this history and are planning a pregnancy, you can see a specialist and have a semen analysis early, without waiting.