Undescended Testicle in Babies: Causes, Timing, and Treatment Explained (2026 Guide)
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: September 2026
Editorial note: This article is based exclusively on authoritative medical sources, including Mayo Clinic (pages updated May 15, 2026), the American Urological Association, NIH/StatPearls, and the Urology Care Foundation. It is for general education only and is not medical advice. If you can't feel a testicle in your baby's scrotum, discuss it at the next well-baby visit — and see a pediatric urologist or pediatric surgeon if the testicle hasn't descended by about 6 months of age.
TL;DR
An undescended testicle (cryptorchidism) is a testicle that hasn't moved into the scrotum before birth — most often one, sometimes both. It affects roughly 3% of full-term boys and up to 30% of premature boys, and usually descends on its own in the first months of life. If the testicle hasn't descended by 3 to 4 months, surgery (orchiopexy) is usually recommended between 6 and 18 months of age, with a success rate of nearly 100% for a single undescended testicle.
Quick Answer: What is an undescended testicle and what do parents do about it?
An undescended testicle (cryptorchidism) is a testicle that has not moved into the scrotum before birth. It is found in about 3% of full-term boys at birth, and most descend on their own within the first months of life. If the testicle is still undescended by about 6 months, specialists usually recommend orchiopexy — a surgery performed between 6 and 18 months that moves the testicle into the scrotum and fixes it in place, with a success rate of nearly 100%.
What is an undescended testicle?
A testicle that doesn't move down into its proper place in the scrotum before birth is called an undescended testicle. It is also known as cryptorchidism (krip-TOR-kih-diz-um). Most often, it is just one testicle that doesn't descend into the scrotum — the bag of skin that hangs below the penis — but sometimes both testicles are affected.
The condition is more common in premature babies than in full-term infants, and an undescended testicle often moves down on its own within a few months after birth. If it doesn't correct itself, surgery can move the testicle into the scrotum.
Normal testicular descent through the inguinal canal, compared with an undescended testicle.
How common is cryptorchidism?
Context helps put a newborn finding in perspective. Roughly 3% of full-term newborn boys have an undescended testicle, and the number drops to about 1% by 6 to 12 months as most descend on their own. Among premature boys, the figure is far higher — about 15% to 30%.
| Group | Prevalence at birth | After ~6–12 months | |---|---|---| | Full-term boys | About 3% (range 1–4.6% in studies) | About 1% — most descend on their own | | Premature boys | About 15–30% | Falls with corrected age | | Boys at 3–4 months still undescended | — | Unlikely to correct itself; usually needs treatment |
What are the symptoms?
Not seeing or feeling a testicle in the scrotum is the main symptom of an undescended testicle.
Testicles form in an unborn baby's lower belly. During the last few months of pregnancy, they typically move down from the stomach area, through a tubelike passage in the groin called the inguinal canal, and into the scrotum. With an undescended testicle, that process stops or is delayed.
When to see a doctor
An undescended testicle is often found during an exam shortly after birth. If your baby has one, ask how often exams will need to be done. If the testicle hasn't moved into the scrotum by 3 to 4 months of age, the condition likely won't correct itself. Treating early — while your child is still a baby — might lower the risk of health problems later in life, including testicular cancer and infertility.
Retractile and ascending testicles: not quite the same thing
Older boys — from infants to preteens — who had descended testicles at birth might appear to be missing a testicle later. Two conditions explain this:
| Condition | What happens | Key difference | |---|---|---| | Retractile testicle | Moves back and forth between the scrotum and the groin, due to a muscle reflex in the scrotum | Can be easily guided by hand into the scrotum during an exam | | Ascending testicle (acquired undescended) | Has returned to the groin after a normal birth descent | Cannot be easily guided by hand into the scrotum |
Three explanations when a testicle seems missing: undescended, retractile, or ascending.
Talk to your child's doctor or another member of their care team if you notice any changes in your child's genitals or have other concerns.
What causes it?
The exact cause of an undescended testicle isn't known. Genes, the health of the baby's mother, and other factors might have a combined effect. Together they may disrupt the hormones, physical changes, and nerve activity that play roles in how the testicles develop.
Who is at higher risk?
| Risk factor | Examples | |---|---| | Birth factors | Premature birth or low birth weight | | Family history | Undescended testicles in the family | | Baby's health conditions | Cerebral palsy or a problem with the wall of the abdomen | | Mother's health before or during pregnancy | Diabetes before or during pregnancy | | Exposures during pregnancy | Alcohol use; smoking or secondhand smoke; exposure to some pesticides |
What complications can arise if it goes untreated?
The testicles need to be slightly cooler than regular body temperature to develop and work well, and the scrotum provides this cooler place. Leaving a testicle out of the scrotum raises several risks:
| Complication | What it involves | |---|---| | Testicular cancer | Men who had an undescended testicle have a higher risk of testicular cancer, which often begins in testicle cells that make immature sperm. Risk is greater when the testicle was in the stomach area rather than the groin, and when both testicles were affected. Surgery might lower the risk, but it doesn't go away completely. | | Fertility problems | More likely in men who had an undescended testicle, and potentially worse when treatment is delayed a long time. | | Testicular torsion | Twisting of the cord that brings blood to the testicle; cuts off the blood supply. Without quick treatment, the testicle may be damaged enough to require removal. | | Trauma | A testicle in the groin can be damaged from pressure against the pubic bone. | | Inguinal hernia | Intestines push into the groin through a weak spot in the abdominal muscles, causing a painful bulge. |
How is an undescended testicle diagnosed?
A pediatrician checks the groin during well-baby visits. If a testicle isn't in the scrotum, the provider tries to find it by lightly pressing against the skin — a lubricant or warm, soapy water may be used. If the testicle can be felt in the inguinal canal, the doctor may try to move it gently into the scrotum:
| Finding on exam | Likely meaning | |---|---| | Moves only partway into the scrotum, movement causes pain, or it snaps right back | Undescended testicle | | Moves somewhat easily into the scrotum and stays for a while | Retractile testicle |
Imaging tests such as ultrasound and MRI are usually not needed to diagnose an undescended testicle. If your baby's testicle hasn't moved down or can't be found by about 6 months of age, a referral to a specialist is typical — a pediatric urologist (trained in children's genital and urinary tract problems) or a pediatric surgeon.
If a baby's testicles can't be found in the scrotum after birth, more tests may be needed to determine whether the testicles are absent — not there at all — rather than undescended, because some health issues that lead to absent testicles can cause serious problems soon after birth if not found and treated.
How is it treated?
The goal of treatment is to move the undescended testicle to its proper place in the scrotum. Treatment before age 1 might lower the risk of health problems such as infertility and testicular cancer — earlier is better, and experts often recommend surgery before the child is 18 months old.
From birth to treatment: the typical timeline for monitoring and orchiopexy surgery.
Surgery (orchiopexy)
Most often, an undescended testicle is fixed with surgery called orchiopexy (OR-kee-o-pek-see). The surgeon moves the testicle into the scrotum and stitches it into place, through a small cut in the groin, the scrotum, or both.
| Surgery aspect | What it involves | |---|---| | Timing | Usually between 6 and 18 months of age, depending on the baby's health and procedure difficulty; early treatment lowers the risk of later problems | | Location of the cut | A small cut in the groin, the scrotum, or both | | Other repairs | An inguinal hernia is repaired during the same surgery if present; damaged or dead tissue is removed if the testicle cannot be saved | | Diagnostic surgery | Laparoscopy (a small camera through a small cut in the belly) may locate a testicle in the stomach area and sometimes fix it in the same procedure; open surgery uses a larger cut into the abdomen or groin | | After surgery | Physical exams, ultrasound exams of the scrotum, and hormone level tests monitor that the testicle develops, works, and stays in place |
Hormone treatment
With hormone treatment, a child is given shots of human chorionic gonadotropin (hCG), which could cause the testicle to move to the scrotum. Hormone treatment often is not recommended, because it is much less effective than surgery.
When a testicle is absent or removed
If your child doesn't have one or both testicles — because they are absent or were removed during surgery — other treatments might help:
| Option | Details | |---|---| | Testicular prosthesis | An artificial implant that gives the scrotum a regular appearance; placed in the scrotum with surgery, at least six months after a scrotum procedure or after puberty | | Endocrinologist referral | If at least one healthy testicle isn't present, a hormone expert can plan future hormone treatments needed to bring about puberty and physical maturing |
What results can you expect?
Orchiopexy is the most common surgery to fix a single undescended testicle, with a success rate of nearly 100%. Most of the time, the risk of fertility problems goes away after surgery for a single undescended testicle. Surgery when both testicles are undescended brings less of an improvement. Surgery also might lower the risk of testicular cancer, but it doesn't eliminate it.
How should parents monitor after treatment?
Even after surgery, it's important to check your baby's testicles to make sure they develop properly — you can check the position during diaper changes and baths.
As your child approaches puberty, talk about the physical changes to expect and explain how your child can check the testicles without help. A monthly self-exam is a key skill for finding lumps and other possible early signs of tumors. See the child's doctor if any unusual changes appear.
Coping and support
A child might be sensitive about how the scrotum looks without one or both testicles, especially in a locker room. Practical support can help:
| Support strategy | How it helps | |---|---| | Teach correct words for the scrotum and testicles | Builds comfort in everyday conversation | | Explain what "missing" means — and that the child is still healthy | Reduces anxiety about looking different | | Emphasize it isn't an illness | Removes a sense of being sick or abnormal | | Discuss a testicular prosthesis if appropriate | Restores a typical appearance | | Practice answers to questions or bullying | Builds confidence with peers | | Loose-fitting boxer shorts and swim trunks | Makes the condition harder to notice when changing or playing sports | | Watch for signs of worry or shame | For example, a child suddenly quitting a sport they used to enjoy |
Preparing for your appointment
Since an undescended testicle is often found at birth, the family doctor or pediatrician monitors it at well-baby visits. Before an appointment, write down questions such as how often to schedule visits, how to safely check the scrotum at home, when a specialist is needed, what tests your child will need, and what treatment options are suggested.
When to see a doctor
See a healthcare professional if:
You can't see or feel one or both testicles in your baby's scrotum at any well-baby visit
The testicle hasn't moved into the scrotum by 3 to 4 months of age
A boy who descended normally at birth later appears to be missing a testicle
Your child has groin or scrotal pain, swelling, or a bulge (possible torsion or hernia — needs urgent care)
Why timing matters
Most undescended testicles descend on their own in the first months of life, which is why watchful waiting through the early weeks is standard. But once the window around 3 to 4 months passes, the condition usually won't correct itself — and the longer a testicle stays out of its cooler place, the greater the potential impact on fertility and the future risk of testicular cancer. Early orchiopexy, typically completed before 18 months, is the proven way to protect your child's long-term health.
Conclusion and next steps
An undescended testicle is one of the most common findings in newborn boys — about 3% of full-term infants, and many more premature babies — and in most cases the testicle finds its way down on its own in the first months of life. What matters most is timing: if the testicle hasn't descended by 3 to 4 months, plan ahead with your pediatrician, and expect surgery (orchiopexy) to be recommended between 6 and 18 months of age, a procedure with a nearly 100% success rate that protects fertility and lowers future cancer risk.
Your next steps: Make sure the condition is documented at your baby's well-baby visits, ask how often the exam should be repeated, and ask when a pediatric urologist referral is needed. If surgery is planned, use the appointment to ask about timing, what the procedure involves, and whether an inguinal hernia will be repaired at the same time. After treatment, keep up the monthly testicle checks — they become a lifelong self-exam habit that catches problems early.
This article is for educational purposes only and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified health care provider for decisions about your child's health.
Frequently Asked Questions
1. What is an undescended testicle? A testicle that doesn't move down into its proper place in the scrotum before birth. It is also called cryptorchidism. Most often one testicle is affected, but sometimes both are.
2. How common is it? About 3% of full-term newborn boys have an undescended testicle, rising to roughly 15–30% in premature boys. Most descend on their own within the first months of life, and only about 1% of full-term boys remain undescended by 6 to 12 months.
3. Will it correct itself? Often, yes — in the first months after birth. But if the testicle hasn't moved into the scrotum by 3 to 4 months of age, the condition likely won't correct itself and treatment is usually recommended.
4. Is it the same as a retractile testicle? No. A retractile testicle moves back and forth between the scrotum and groin due to a muscle reflex and can be guided by hand into the scrotum during an exam. An ascending (acquired) testicle has returned to the groin and cannot be easily guided back down. Your doctor can tell the difference.
5. How is it treated? Most often with surgery called orchiopexy, performed between 6 and 18 months of age. The surgeon moves the testicle into the scrotum and stitches it into place. The success rate for a single undescended testicle is nearly 100%, and early treatment lowers the risk of later fertility problems.
6. Does it affect fertility? An undescended testicle makes future fertility problems more likely, especially when treatment is delayed a long time. After surgery for one undescended testicle, the risk of fertility problems usually goes away; with two undescended testicles, the improvement from surgery is less complete.
7. Does it cause testicular cancer? Men who had an undescended testicle have a higher risk of testicular cancer, particularly when the testicle was in the stomach area or when both were affected. Surgery might lower that risk, but it doesn't eliminate it — which is why lifelong monthly self-exams matter.
8. What should parents do first? Have the condition noted at well-baby visits and follow the monitoring schedule. Ask about a specialist referral if the testicle hasn't descended by about 6 months. Avoid imaging tests such as ultrasound or MRI unless a specialist recommends them — they usually aren't needed for diagnosis.
Related reading
Testicular Cancer: The Young Man's Cancer That's Highly Curable — Symptoms, Self-Exam Guidance, and Treatment Explained — men who had an undescended testicle face a higher lifetime risk, so knowing the warning signs matters.
Premature Birth: Complete Guide to Signs, Causes, and Care — premature babies are far more likely to have an undescended testicle at birth.
References
Mayo Clinic — Undescended testicle: Symptoms and causes (updated May 15, 2026)
Mayo Clinic — Undescended testicle: Diagnosis and treatment (updated May 15, 2026)
American Urological Association — Evaluation and Treatment of Cryptorchidism Guideline (2025)
Nguyen V, et al., 2023 — Cryptorchidism (American Family Physician)
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