There are many causes of male infertility. One condition that can contribute is cryptorchidism, which means hidden testis. This is incomplete testicular descent in the scrotum and may be in one or both of the testicles.

The testicles descend to a scrotal position in humans in order to help with sperm production. An undescended testicle(s) may lead to male infertility. A semen analysis will show absence of spermatozoa, which is called azoospermia. Absence of spermatozoa in the semen is due to problems with germ cell maturation.

Facts about cryptorchidism

  • 3 percent of full-term and 30 percent of premature infants are born with at least one undescended testicle.
  • At least 80 percent of cryptorchid testicles descend spontaneously by the first year of life.
  • Corrective surgery called orchidopexy must be performed before puberty, preferably during the first 3 years of life in order to minimize germ cell loss. Orchidopexy moves an undescended testicle into the scrotum.
  • Risk of testicular cancer (germ cell tumor) is 4 times higher in individuals with undescended testis.

Male infertility & treatment

Ultrasonography can help identify a testicle located in the inguinal canal but is of limited use for intra-abdominal testes. MRI and CT scan can be useful for intra-abdominal testes and overall location of any undescended testicle. This can be used to help with specialized procedures when attempting to retrieve the undescended testicle or perform a biopsy of the testicle.

Intra cytoplasmic sperm injection (ICSI) allows sperm with limited fertilizing ability to produce usable embryos. According to several recent studies, testicular sperm extraction (TESE) may be attempted in patients with history of cryptorchidism. The procedure is successful in 50 percent of the cases.

1. Seo JT et al. Predictive factors of successful testicular sperm recovery in non-obstructive azoospermia patients. Int J. Androl 2001; 24 (5) 306-10.
2. Marcelli F. et al. Results from TESE in azoospermia due to cryptorchidism: A ten year experience with 142 patients. Prog Urol, 2008: 18 (10) 657-62.
3. Chung Eric et al. Cryptorchidism and its impact on male infertility: a state of art review of current literature. Can Urol Assoc J. 2011: 5 (3) 210-14.
4. Saxena, A. (2016). Causes and Treatments for Undescended Testes. Retrieved June 01, 2016, from

Call us at (404) 228-7199 (Atlanta), (706) 724-0228 (Augusta) or request an appointment online with our fertility specialists to talk to us about ICSI and TESE procedures to treat male infertility.