In terms of infertility, bilateral cryptorchidism (in which both testicles failed to descend) poses a bigger problem than unilateral cryptorchidism (in which only one testicle failed to descend). This with unilateral cryptorchidism showed a 17-30% decrease in normal sperm density, while with with bilateral cryptorchidism showed around a 50% decrease.

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Another issue can be the incidence of azoospermia – a condition in which there is little to no sperm found in the semen. This instance in unilateral cryptorchidism was found to be 13%, which bilateral cryptorchidism was up to 89%.[4]

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Treatment for cryptorchidism-caused infertility

Currently, treatment for cryptorchidism based infertility varies case by case. Hormone therapy may be suggested to raise testosterone levels. However, this is still seen as controversial.[5]

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In vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) is another available treatment. In IVF, a woman’s eggs are extracted and fertilized. After 3 or 5 days of incubation, the surviving embryos are placed back inside the woman in hopes of conception. With ICSI, an embryologist will pick one sperm to inject into the woman’s egg for fertilization.

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Sperm can be found using a process called the microTESE. During microTESE (microscope-assisted testicular sperm extraction), a doctor will use a small microscope to retrieve tissue from the testicles that may contain sperm. This is the best chance to find usable sperm without damaging the testicles or testicular tissue. For more information on IVF or ICSI, please visit the respective pages in the menu above.

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If IVF is not possible or doesn’t work, donor sperm is available for use. This decision may be difficult for some. It is important to weigh all options and make sure to be emotionally okay with it. For more information on donor sperm, please visit the Donor page in the menu above.