The single testis: paternity after presentation as unilateral cryptorchidism

Area of Science:

• Andrology
• Reproductive Medicine
• Pediatric Surgery

Background:

• Undescended testes (cryptorchidism) affect male reproductive health.
• Monorchidism, resulting from an absent or removed testis, can impact fertility.
• Surgical correction (orchiopexy) is common for childhood cryptorchidism.

Purpose of the Study:

• To investigate if paternity is reduced in men with monorchidism compared to those with corrected unilateral cryptorchidism and controls.
• To assess paternity rates in men with a single testis, regardless of the cause (congenital absence or orchiectomy).

Main Methods:

• Retrospective medical record review and detailed questionnaire.
• Inclusion of men who attempted or achieved paternity with complete data.
• Comparison of paternity success rates between groups: absent testis, orchiectomy, corrected cryptorchidism, and controls.

Main Results:

• Paternity success rates did not significantly differ among groups: absent testis (100%), orchiectomy (85%), corrected cryptorchidism (89.7%), and controls (93.2%).
• No difference in paternity was observed in subgroups based on testicular appearance at surgery or timing of orchiectomy.
• Men with a single testis (monorchism plus orchiectomy) showed comparable paternity rates to corrected unilateral cryptorchidism and control groups.

Conclusions:

• Paternity is not diminished in men with a single testis compared to the general population.
• The origin of testis loss (congenital absence or surgical removal) did not affect paternity outcomes.
• Approximately 12% of testes initially deemed impalpable were found to be absent upon surgical exploration.