After surgery, will the child’s fertility as an adult be comparable to that of the general population?

If cryptorchidism is unilateral and the contralateral testicle is healthy, normal sperm and testosterone production will be maintained, and the child’s subsequent growth and development will not be affected. In cases of bilateral cryptorchidism, the functional quality of the testes themselves determines the outcome. If the testes are structurally and functionally intact, normal sperm and sex hormone production can typically resume following surgical correction (orchiopexy).

Thus, growth and development remain unaffected. However, the rate of infertility—despite natural conception attempts—is higher than in the general population, estimated at approximately 20–30%, compared with ~10% in healthy individuals. Conversely, if both testes are severely underdeveloped—for example, reduced to the size of soybeans—sperm and testosterone production will likely remain absent even after surgical intervention.

In such cases, serum testosterone levels should be reassessed at age 7 years. Hormone replacement therapy may then be initiated, tailored to the child’s blood hormone concentrations, to support appropriate pubertal development and secondary sexual characteristics. Affected individuals can marry and maintain a normal sex life, but will be infertile. Additionally, if orchiopexy is performed after age 7, annual testicular ultrasound surveillance is recommended in adulthood to enable early detection of potential testicular malignancy.