Cryptorchidism and fertility, testicular size and infertility, and the effects of radiation on fertility

Does cryptorchidism affect male fertility?

Normally, the testicles are located in the scrotum. The temperature of the testicles is 1-2°C lower than body temperature, which is conducive to sperm growth and maturation. Testicles develop in the abdominal cavity and gradually descend during fetal development. Most testicles are already in the scrotum at birth. Approximately 10-15% of infants are born with undescended testicles; most of these descend spontaneously within the first year of life. If an infant is one year old and one or both testicles have not descended, remaining in the abdominal cavity or inguinal canal, this is called cryptorchidism.

The testes are the organs that produce sperm in the human body, and the scrotum is the most suitable site for their normal growth and development. If, for various reasons, the testes fail to descend into the scrotum and remain in other locations, and the temperature and biochemical environment of these locations are unfavorable for testicular growth and development, then the testes in those locations will be underdeveloped or not developed at all, and in this case, the testes cannot perform their spermatogenic function. Bilateral undescended testes often result in infertility; after bilateral orchiopexy, 44% can conceive after marriage. If it is a unilateral lesion, 75% can conceive after orchiopexy. Whether it is unilateral or bilateral cryptorchidism, early treatment is essential to avoid future complications such as affecting fertility, malignant transformation, and torsion.

Is testicular size related to male infertility?

Testicular size is related to age. From newborns to children under 12 years old, the testes are in a relatively quiescent period, with a volume of about 1-4 ml. After age 12, boys enter puberty, and the testicular volume increases rapidly. The testicular volume of adult males is 12-25 ml, with an average of 16.8 ml. After age 60, sexual decline begins, and the testicular volume gradually decreases. After age 70, the testicular volume can shrink to less than 16 ml. If the testicular volume of an adult is less than 10 ml, it is considered microtestis, which can lead to hypogonadism and male infertility. Small testes can cause impaired spermatogenesis, resulting in low sperm count or no sperm, and in most cases, loss of fertility. Examinations may reveal very low plasma testosterone levels, underdeveloped secondary sexual characteristics such as sparse facial, pubic, and axillary hair, a high-pitched voice, and in severe cases, feminization. Most patients experience low libido and hypogonadism. The main diseases that cause small testes include Klinefelter syndrome, congenital adrenal hyperplasia, and some hereditary diseases. Testicular hypoplasia is often caused by testicular tumors, epididymal tuberculosis, hydrocele, and other diseases. If these conditions are not treated promptly, they can also affect fertility or lead to poor sperm and semen quality, thus causing infertility.

Does radiation affect male fertility?

Radiation refers to beams of particles generated by radioactive materials or artificial equipment. In medicine, X-rays are the most widely used, such as in X-ray machines, CT scanners, and radiotherapy machines. Additionally, there are gamma rays produced using radium, cobalt, etc., such as those used in gamma knife therapy. Radiation is particularly easy to overlook because of excessive computer use.

It is well known that radiation poses a serious threat to the human hematopoietic system. Similarly, radiation also significantly harms male reproductive function. Testicular tissue is highly sensitive to radiation. Small doses or short-term exposure to radiation will affect spermatogenesis to some extent, but this is usually recoverable. However, large doses or prolonged exposure to small doses can cause irreversible damage to spermatogenic cells, leading to decreased spermatogenesis and male infertility. For those working with radiation without proper protection, radiation can cause chromosomal aberrations or mutations in spermatogenic cells, even resulting in severe spermatogenesis damage. Even if pregnancy is possible, it can lead to birth defects, miscarriage, or premature birth. Furthermore, frequent radiological examinations or treatments can also affect male fertility. Additionally, some people whose work requires prolonged exposure to radioactive materials can also negatively impact their fertility.

With the widespread use of mobile phones and computers, the impact of radiation emitted by these devices on the human body is currently inconclusive. Some say it affects vital organs such as the brain and heart, while others say it has little effect. Currently, many scholars believe that prolonged computer use is harmful to sperm production.

In conclusion, people, especially men of childbearing age, should pay more attention to learning about protection in this regard and try to avoid excessive exposure to radiation.