Cryptorchidism in the subfertile male

Certain conclusions may be drawn from the present review and presentation of new data concerning the unilaterally cryptorchid patient and possible subfertility: 1. The truly undescended testis--not the retractile testis of infancy--will not descend spontaneously after 1 year of age. 2. The seminal quality of the unilaterally cryptorchid patient is definitely impaired, although not rendered infertile, in a great majority of patients irrespective of the time of surgery. 3. The dystopic position of the maldescended testis appears to superimpose a second insult on what very likely may be an inherent abnormality in the cryptorchid testis, the latter accounting, perhaps, for its abnormal extrascrotal position. 4. Orchiopexy before the age of 5 seems advisable to ensure minimal histologic changes that may be secondary to the testis' increased exposure to elevated extrascrotal temperature. 5. The cryptorchid testis will be smaller in size irrespective of surgery, and usually correlates with significant testicular pathology. 6. Basal levels of gonadotropins, especially follicle-stimulating hormone, are likely to be elevated, but this does not necessarily imply overwhelming testicular damage. Androgen production should not be affected. 7. Surgical correction is advised when human chorionic gonadotropin stimulation fails to produce teticular descent, thereby defining the maldescended testis as not merely retractile but truly "crytorchid."