Male fertility and the undescended testis in Down syndrome. How to counsel parents

Evaluation of fertility in male patients with Down syndrome has generally revealed poor psychosexual adaptation and markedly abnormal semen quality, which have thus far been uniformly associated with sterility. Up to 50% of male patients with Down syndrome have undescended testes. Life-table analysis of survival among patients with Down syndrome, as well as the low incidence of testicular tumors, would suggest that orchidopexy may be unnecessary in some patients. In most patients, however, orchidopexy is appropriate to allow for subsequent testicular examination. Parents of children with Down syndrome must be appropriately counseled regarding the fertility of their children and the treatment options for cryptorchidism.