Hello Doctor,
I am a 27-year-old male with an undescended testis. Recent imaging showed the testis size to be approximately 9 × 6 × 7 mm.Right side testis is absent
I have been diagnosed with azoospermia. My hormonal tests were repeated twice and showed similar results:
FSH: Normal
LH: Elevated
Prolactin: Normal
Testosterone: Normal
I would like your opinion on the following:
Is orchiopexy still beneficial at my age?
Can the undescended testis be contributing to my azoospermia?
What does a high LH with normal testosterone indicate in my case?
Are there any additional tests you recommend (genetic tests, testicular biopsy, semen analysis repetition, etc.)?
What are the chances of improving fertility after treatment?
Would you recommend orchiopexy, orchiectomy, or any other management?
Answers (20)
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This is a complex case that needs specialist input from a urologist/andrologist. The small testis size and azoospermia indicate severely reduced sperm production from that side. The elevated LH with normal testosterone is a sign of compensated testicular dysfunction â your body is working harder to maintain hormone levels, which means the testicular reserve is reduced. At age 27, orchiopexy has minimal benefit for fertility (the optimal window is before age 2), though it may still be discussed for cancer risk reduction. The combination of cryptorchidism and azoospermia with normal FSH makes genetic testing important â Y chromosome microdeletion and karyotype must be done, as results will directly influence whether surgical sperm retrieval (TESE/micro-TESE) is worthwhile.
Next Steps
Please see a urologist/andrologist urgently. Key next steps are karyotype, Y chromosome microdeletion testing, and testicular biopsy. Please consult me directly on Practo for a detailed evaluation.
You need surgical intervention to decent down testies as early as possible as u r facing azoospermia.
In stomach temperature is high in scrotum its cool n airey.
Sir based on the information you have provided Orchideopexy would be the better option as it is important to bring down the testis to prevent testicular torsion and also since right testis is absent preserving and operating early is best as it prevent the risk of developing testicular tumor in future
Next Steps
Yes undescended tests is the reason your azospermia .Certain genetic tests, semen analysis,clinical examination would be required.
Health Tips
The surgery should have been done at 6-18 months at your childhood would have had better chances of fertility.Opertaing now also could be opted
Need few more details for proper understanding of your issue.
You can consult with me online on Practo or whatsapp on eight three one eight four six nine eight eight six for proper diagnosis, conclusion and management
Orchiopexy (orchidopexy) is a surgical procedure to move a testicle into the scrotum and permanently secure it in place.
More more discussion you can contact me directly on Practo
At age 27, orchiopexy is unlikely to improve fertility significantly, especially with a very small undescended testis. The undescended testis may contribute to azoospermia, particularly if the other testis is absent.
High LH + normal testosterone suggests compensated testicular dysfunction.
Recommended: repeat semen analysis, genetic testing (karyotype + Y-chromosome microdeletion), and consultation with an andrologist/urologist.
Depending on examination and imaging, orchiopexy or orchiectomy may be advised. Natural fertility improvement is usually low, but sperm retrieval techniques (micro-TESE) with IVF/ICSI may still be possible.
Treatment for an undescended testicle in adults generally involves surgery (orchiopexy) to reposition the testicle into the scrotum or, depending on functionality and age, testicle removal (orchiectomy).
As you are young and keen on fertility, think of orchiopexy.
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
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