Will small testicles affect fertility?

The testicle refers to a part of the male reproductive organ, and the testicle is also a relatively sensitive and fragile part for men. Small testicles are a common problem for many men. There are two types of small testicles: pathological and physiological. Pathological small testicles can easily affect normal fertility and need to be treated in time.

Will small testicles affect fertility?

Small testicles can be divided into physiological and pathological ones. Physiological small testicles generally do not affect fertility as long as they can produce enough normal sperm. There are many reasons for pathological testicular shrinkage, the most common of which are chronic wasting diseases, endocrine disorders, persistent high fever, taking large amounts of female hormones, viral orchitis, testicular syphilis, etc. These diseases can cause the testicles to atrophy, so that the volume is smaller than normal. Pathological testicular atrophy and shrinkage is usually due to the spermatogonia or spermatocytes of the seminiferous tubules being easily affected. When these cells atrophy and cannot produce sperm, or are damaged and cannot produce normal sperm, the testicles will be smaller as mentioned above. In addition, it is often accompanied by infertility; however, because interstitial cells that secrete androgens are less involved, it generally does not affect the development of male reproductive organs and male secondary characteristics. From a clinical point of view, it is rare for severe testicular atrophy to cause infertility. Testicular atrophy is accompanied by fertility disorders, and semen microscopy can be performed. If the number of spermatozoa per milliliter of semen is less than 20 million, the activity function is reduced, and the morphology is abnormal, infertility should be considered.

Testicular volume

The testicle is an important male reproductive gland. It is the base for sperm production and the place where a large amount of androgen is secreted. It is also an important organ for reproduction and maintaining secondary sexual characteristics. The individual variation of the testicle volume of normal adult men is very large, and the testicles on both sides of a normal person are not exactly the same.

reason

Overview

Some people have testicles that are one large and one small since childhood, and the difference is very obvious. This is mostly caused by congenital diseases. Among the congenital causes, there are two common ones: one is congenital testicular dysplasia, which is caused by a disease called Kleinfeldt syndrome, which is also called seminiferous tubule dysplasia. About one in 500 male babies has this disease. This disease is mainly caused by abnormal sex chromosomes. Normal males have 46 chromosomes, represented by 46, XY. Patients with Kleinfeldt syndrome have an extra sex chromosome X, and their karyotype is 47, XXY. The reasons may be that the mother's oocytes did not undergo meiosis during mitosis and formed double X eggs, or that the father's sperm was abnormal during production. Such people are usually normal in childhood, but only gradually develop abnormal behaviors during adolescence or adulthood.

Symptoms

Most of these patients have delayed puberty, that is, their testicles are still the size of a child after the age of 14. Male secondary sexual characteristics are not obvious, such as tall stature, long and thin limbs, narrow shoulders, a wide pelvis similar to that of a woman, underdeveloped muscles, and more subcutaneous fat, with a tendency to obesity. They have a sharp voice, Adam's apple, unclear or sparse beard and body hair. 80% of patients may have female manifestations such as enlarged breasts, but do not secrete milk. The external genitalia are male-shaped, the penis is normal or short, and even in adulthood, the testicles are small and hard. The intellectual development of these patients may be normal or slightly delayed. Another type of microtestis is congenital adrenal hyperplasia, which is caused by congenital 21-hydroxylase deficiency. The adrenal glands need this enzyme to participate in the process of synthesizing cortisone from cholesterol. If 21-hydroxylase is deficient, cortisone synthesis will decrease; on the contrary, the synthesis of androgen (testosterone) in the adrenal glands will increase significantly. Under the action of excessive androgen, the patient will show precocious puberty, and male secondary sexual characteristics will appear before the age of 10, but the testicles are small. This is because the testosterone produced by the adrenal glands can inhibit the pituitary gland from secreting gonadotropin, thereby inhibiting the development of the testicles, so this kind of precocious puberty is also called pseudo-precocious puberty. In addition to the two common congenital causes, there are also many cases of different testicle sizes caused by acquired factors. For example, if one side of the testicle is injured, it can cause bleeding and hematoma in the testicle, which results in insufficient blood supply to the testicle, which gradually shrinks and becomes significantly smaller than the other side. The mumps virus can damage the epithelial cells of the seminiferous tubules in the testicle, which is also one of the important reasons for one testicle being larger than the other.