Unraveling the Connection: Testicular Torsion & Sperm Health

Testicular Torsion and Male Fertility

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Testicular health and fertility are subjects of vital concern to men and couples aspiring to start a family. Among the various factors that can impact male fertility, testicular torsion (TT) has emerged as a significant topic of interest. TT is an uncommon yet critical urological emergency that mainly affects children and adolescents. In this blog, we delve into the relationship between testicular torsion and male infertility, unraveling its complexities and addressing commonly asked questions.


Understanding Testicular Torsion

Testicular torsion involves the twisting of the spermatic cord that supplies blood to the testicle. This condition can lead to ischemia (restricted blood flow) and potential damage to the testicle if not promptly treated. TT often presents as sudden and severe testicular pain and swelling and requires urgent medical attention to prevent permanent damage.


Effects of Testicular Torsion on Male Fertility

Research has explored whether TT, particularly when experienced at an early age, has long-term implications for male fertility. A comprehensive study investigated the impact of unilateral testicular torsion on adult male fertility. It found that the onset of TT during childhood did not significantly affect fertility in adulthood. In fact, the study observed a relatively high pregnancy rate among couples where the male partner had experienced TT during childhood. This intriguing discovery challenges some of the previously held beliefs regarding the link between TT and fertility.


Age Matters: The Role of Timing

One of the striking findings of the study was the influence of age at the time of TT on fertility outcomes. The research indicated that the pregnancy rate was higher among individuals who had experienced TT during childhood compared to those who experienced it during adolescence or adulthood. This suggests that the compensatory mechanisms within the unaffected testicle play a significant role in fertility preservation. As age at the time of TT increases, these compensatory abilities appear to diminish.


Preservation vs. Removal: Surgical Considerations

The study also shed light on the impact of surgical interventions on fertility. When TT occurs, prompt treatment is crucial. Surgical options include orchiectomy (removal of the affected testicle) or surgical repositioning (reversing the torsion and restoring blood flow). The research indicated that couples where the affected testicle was preserved had better fertility outcomes compared to those where orchiectomy was performed. This underscores the importance of considering preservation whenever possible, especially for individuals over the age of 18.


Clinical Implications

Understanding the relationship between TT and male fertility has several clinical implications:

  1. Urgent Treatment: Early intervention within 6 hours of TT onset is crucial to prevent irreversible damage.
  2. Diagnostic Accuracy: Color Doppler flow imaging (CDFI) is an effective tool for diagnosing TT and assessing blood flow.
  3. Preservation Priority: Whenever feasible, preserving the injured testicle can lead to better fertility outcomes.
  4. Age-Related Impact: Age at the time of TT plays a significant role in determining fertility status in adulthood.


The complex interplay between testicular torsion and male fertility continues to unfold through scientific research. The findings of recent studies challenge traditional assumptions, demonstrating that while early-life TT might not significantly impact fertility, age at the time of TT does influence fertility outcomes. This knowledge empowers medical professionals to make informed decisions and guide patients toward appropriate treatments. As we uncover more about the intricate relationship between TT and male fertility, individuals and couples can be better equipped to navigate these concerns with confidence.

If you’d like to know if your sperm is healthy, one of the best indicators to predict a successful pregnancy from the male side is looking at Total Motile Sperm Count. This is the estimated total number of sperm cells that are swimming in a progressive motion in 1 ejaculate. The ExSeed at-home sperm test measures Total Motile Sperm Count, all without you needing to go to a clinic or send away your sperm sample in the mail – check it out here!

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Wearing tight pants and underwear

Studies show that men who wear looser underwear have higher sperm concentration and total sperm count compared to men who wear tighter underwear. So, lose the tight clothes and wear something loose to give your testicles some air.

CONCLUSION: learn more about how heat can affect sperm quality here.


Besides higher mortality rate and various diseases, stress is associated with low sperm quality. Stress is known to be associated with lower testosterone levels and oxidative stress with both playing an essential role in producing and maintaining healthy sperm cells.

CONCLUSION: If you feel stressed, we recommend you get some help so you can have a balanced mental health. For a stress management guide, download the ExSeed app for free and start your personalized action plan today.

Physical activity

Scientific studies show that men who are physically active have better semen parameters than men who are inactive. Fertility specialists also state that regular physical activity has beneficial impact on sperm fertility parameters and such a lifestyle can enhance the fertility status of men.

Prioritizing exercise can help improve your overall health and result in healthy, fast swimming sperm cells that have good chances of fertilizing an egg.

CONCLUSION: Try incorporating exercise in your weekly schedule to you ensure exercising at least twice weekly. We recommend a combination of cardio training and strength exercise. Read more about exercise and male fertility on our blog.


Fast Food
Processed foods damage the health of sperm-producing cells and cause oxidative stress, which lead to poorer sperm quality. Heavy consumption of junk food (every week) can increase the likelihood of infertility since men who consume vast amounts of unhealthy food are at risk of having poor sperm quality. Besides harming your fertility, junk food enlarges your waistline, harms your cardiovascular system, kidneys, and more.

Eating more fruit and vegetables can increase your sperm concentration and motility. It’s important that you consume a healthy diet filled with antioxidants and that you eat vegetables every day. Foods such as apricots and red bell peppers are high in vitamin A, which improves male fertility by nurturing healthier sperm. Men who are deficient in this vitamin tend to have slow and sluggish sperm.

Sugary snacks/beverages: several times a week Excessive consumption of high sugar items can lead to oxidative stress, which negatively impacts testosterone levels and sperm motility. Sugary snacks and beverages are also highly associated with obesity and low fertility.
CONCLUSION: To boost sperm quality, stay away from fast food, processed food, and sugary snacks or beverages. You need to implement a healthy prudent diet filled with necessary superfoods needed for good sperm production. Check out our guide to Male Fertility Superfoods. For personalized guidance and support on how you can start improving your sperm health, check out the Bootcamp.


Direct heat can inhibit optimal sperm production and cause Sperm DNA damage. Sperm cells like environments that are a couple of degrees lower than body temperature. Avoid overheating from warm blankets, seat warmers, heat from your laptop, hot showers, and saunas.

Cigarette smoking

The exposure to tobacco smoke has significant negative effects on semen quality. The damage of cigarettes and nicotine of course depends on how many cigarettes you smoke per day and for how long, but even low usage (up to 10 cigarettes / day) can inhibit healthy sperm production.  

CONCLUSION: Stay as far away from cigarette smoking as possible if you care about your general health and your fertility. Read more here.

Cell phone

When you have your cell phone in your front pocket, your testicles are exposed to electromagnetic radiation, which studies have shown to damage the sperm cells. Put your phone in the back pocket of your pants or in your jacket pocket.


There is a clear association between obesity and reduced sperm quality. At least part of the reason for this is that obese men may have abnormal reproductive hormonal profiles, which can impair sperm production and lead to infertility. 

A BMI higher than 30 can lead to several processes in the body (overheating, increase in oxidative stress in the testes, sperm DNA damage, erectile dysfunction) that can have a negative impact on male fertility. This can result in problems when trying to conceive.  

CONCLUSION: BMI is one of the risk factors that influence semen quality and, for example, sperm motility.  


A beer or glass of wine now and then do not really harm sperm quality. But excess alcohol drinking (more than 20 units per week) can reduce the production of normally formed sperm needed for a successful pregnancy.

CONCLUSION: If you want to stay safe, stay under 14 units of alcohol per week. For more information on how alcohol can affect male fertility, take a look at our blog: “Alcohol and Sperm Quality”.


Studies show that women younger than 35 and men younger than 40 have a better chance of getting pregnant. Men can produce sperm cells almost through their entire life, but the sperm cell DNA is more fragile and prone to damage after the age of 40.

As men age, their testes tend to get smaller and softer resulting in a decline in sperm quality and production. These changes are partly because of an age-related decrease in testosterone level, which plays a very important role in sperm

production. Higher male age (>40 years) is not only associated with a decline in sperm production but also with increased sperm DNA fragmentation and worsened morphology (shape) and motility (movement). These negative effects make the sperm cells less qualified for egg fertilization.

CONCLUSION: with an age under 40, you shouldn’t have to worry much about age as a factor in itself. However, studies have shown a slow decline after the age of 30-35 years

and if you are above 40 years of age, your sperm quality can be affected due to increased sperm DNA damage resulting in a decrease of sperm motility and concentration. Remember that you cannot evaluate the quality of a sperm sample by just looking at it – this requires a sperm analysis.