Baby Undescended Testicle (Cryptorchidism)
Medically reviewed by Dr. Michael Okonkwo, MD, FAAP · Board-Certified Neonatologist
Content reviewed against published AAP, AAP, CDC guidelines
Last reviewed:
If your baby has been diagnosed with or you suspect baby undescended testicle (cryptorchidism), here is what the evidence says.
The short answer
Undescended testicle (cryptorchidism) is one of the most common conditions in baby boys, occurring in about 3-5% of full-term and up to 30% of premature newborns. Many undescended testicles come down on their own within the first 3-6 months. If a testicle has not descended by 6 months, surgery (orchiopexy) is recommended before 12-18 months to protect future fertility and reduce other risks.
Key takeaways
- Undescended testicle (cryptorchidism) is one of the most common conditions in baby boys, occurring in about 3-5% of full-term and up to 30% of premature newborns. Many undescended testicles come down on their own within the first 3-6 months. If a testicle has not descended by 6 months, surgery (orchiopexy) is recommended before 12-18 months to protect future fertility and reduce other risks.
- Usually normal when: Your newborn has one or both testicles that have not yet descended, especially if your baby was born premature
- Call your doctor if: Sudden pain, swelling, or redness in the scrotum or groin area, which could indicate testicular torsion (a twisted testicle cutting off blood supply), an incarcerated hernia, or infection requiring emergency evaluation
- Varies by age — see the age-by-age breakdown below
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Parents everywhere have the same worry. You are doing the right thing by looking into it.
What Parents Should Know
According to AAP, CDC guidelines, undescended testicle (cryptorchidism) is one of the most common conditions in baby boys, occurring in about 3-5% of full-term and up to 30% of premature newborns. Many undescended testicles come down on their own within the first 3-6 months. If a testicle has not descended by 6 months, surgery (orchiopexy) is recommended before 12-18 months to protect future fertility and reduce other risks. At 0-3 months, your pediatrician will check for descended testicles at birth and subsequent visits. In many premature and some full-term boys, one or both testicles have not yet descended at birth. The testicles usually descend on their own during the first few months. A retractile testicle, which sometimes pulls up into the groin due to a normal reflex but can be gently guided back into the scrotum, is different from a truly undescended testicle and does not require treatment. It is generally considered normal when your newborn has one or both testicles that have not yet descended, especially if your baby was born premature. However, you should contact your pediatrician promptly if sudden pain, swelling, or redness in the scrotum or groin area, which could indicate testicular torsion (a twisted testicle cutting off blood supply), an incarcerated hernia, or infection requiring emergency evaluation.
Normal vs. Concerning
By Age
What to expect by age
0-3 months
Your pediatrician will check for descended testicles at birth and subsequent visits. In many premature and some full-term boys, one or both testicles have not yet descended at birth. The testicles usually descend on their own during the first few months. A retractile testicle, which sometimes pulls up into the groin due to a normal reflex but can be gently guided back into the scrotum, is different from a truly undescended testicle and does not require treatment.
3-6 months
Most spontaneous descent happens by 3-6 months. If the testicle has not descended by 6 months of age, it is unlikely to come down on its own. Your pediatrician will likely refer you to a pediatric urologist or surgeon. Hormonal treatment is generally not recommended as studies have not shown consistent benefit.
6-12 months
If the testicle remains undescended, surgical correction (orchiopexy) is recommended. The AAP and most pediatric urology guidelines recommend performing surgery between 6-12 months of age. Earlier surgery appears to offer better outcomes for testicular development and future fertility. Orchiopexy is a very common, well-established procedure with excellent success rates (about 95%).
12-18 months
Surgery should ideally be completed by 12-18 months. Delayed treatment beyond this window is associated with increased risks to fertility and a slightly higher risk of testicular cancer later in life (though the absolute risk remains low). After successful orchiopexy, the testicle is monitored at routine checkups to ensure it remains in proper position.
What to Tell Your Pediatrician
- Describe when you first noticed baby undescended testicle (cryptorchidism) and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if you cannot feel your baby's testicle in the scrotum or it does not seem to be in the right position at any well-child visit.
- Mention if one side of the scrotum looks consistently empty or smaller than the other.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Your newborn has one or both testicles that have not yet descended, especially if your baby was born premature
- A testicle that sometimes moves up into the groin but can be gently guided back down into the scrotum (retractile testicle)
- The testicle has descended on its own within the first 3-6 months of life
- After orchiopexy surgery, the testicle is in the scrotum and the surgical site is healing normally
- You cannot feel your baby's testicle in the scrotum or it does not seem to be in the right position at any well-child visit
- One side of the scrotum looks consistently empty or smaller than the other
- Your baby's testicle has not descended by the 4-month checkup and you want to discuss next steps
- A testicle that was previously in the scrotum no longer seems to be there (acquired undescended testicle)
- Sudden pain, swelling, or redness in the scrotum or groin area, which could indicate testicular torsion (a twisted testicle cutting off blood supply), an incarcerated hernia, or infection requiring emergency evaluation
- Your baby has an undescended testicle combined with a bulge in the groin that becomes hard, painful, or discolored, which could indicate an inguinal hernia needing urgent attention
What You Can Do at Home
- Keep track of when you notice baby undescended testicle (cryptorchidism) — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that your newborn has one or both testicles that have not yet descended, especially if your baby was born premature — this is generally within the range of normal.
- At 0-3 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Follow any care instructions from your pediatrician. Keep a written log of symptoms to bring to appointments.
- While monitoring at home, seek immediate care if sudden pain, swelling, or redness in the scrotum or groin area, which could indicate testicular torsion (a twisted testicle cutting off blood supply), an incarcerated hernia, or infection requiring emergency evaluation.
Related Resources
Frequently asked questions
Is baby undescended testicle (cryptorchidism) normal?
When should I call the doctor about baby undescended testicle (cryptorchidism)?
When is baby undescended testicle (cryptorchidism) normal?
What causes baby undescended testicle (cryptorchidism)?
What should I mention to my pediatrician about baby undescended testicle (cryptorchidism)?
Is baby undescended testicle (cryptorchidism) normal at 0-3 months?
Is baby undescended testicle (cryptorchidism) normal at 3-6 months?
Should I go to the ER for baby undescended testicle (cryptorchidism)?
Does baby undescended testicle (cryptorchidism) go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Baby Undescended Testicle (Cryptorchidism).
Things to mention
- Describe when you first noticed baby undescended testicle (cryptorchidism) and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if you cannot feel your baby's testicle in the scrotum or it does not seem to be in the right position at any well-child visit.
- Mention if one side of the scrotum looks consistently empty or smaller than the other.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- You cannot feel your baby's testicle in the scrotum or it does not seem to be in the right position at any well-child visit
- One side of the scrotum looks consistently empty or smaller than the other
- Your baby's testicle has not descended by the 4-month checkup and you want to discuss next steps
Urgent signs to report immediately
- Sudden pain, swelling, or redness in the scrotum or groin area, which could indicate testicular torsion (a twisted testicle cutting off blood supply), an incarcerated hernia, or infection requiring emergency evaluation
- Your baby has an undescended testicle combined with a bulge in the groin that becomes hard, painful, or discolored, which could indicate an inguinal hernia needing urgent attention
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of baby undescended testicle (cryptorchidism) are normal. Talk to your pediatrician if sudden pain, swelling, or redness in the scrotum or groin area, which could indicate testicular torsion (a twisted testicle cutting off blood supply), an incarcerated hernia, or infection requiring emergency evaluation.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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