Hypospadias and Having Children

Hypospadias alone is not a cause of infertility. The problem is usually not with sperm production but with how semen is delivered: when the opening sits further back, semen cannot be projected forward with enough force, it can leak backward, or the sensation of ejaculation is weaker.

• In other words, the issue is mechanical, not one of production. This distinction matters, because a mechanical problem can be corrected with repair.

When proximal hypospadias is accompanied by a condition such as undescended testes, the production side should also be evaluated. So the first step is not to guess, but to measure.

• Sperm analysis (semen analysis) — the most basic and most informative test.
• Hormone profile.
• Assessing where semen exits from during ejaculation.
• Testicular examination and ultrasound if needed.
• Evaluation of any accompanying curvature or stream problems.

• For a mechanical problem, channel repair — moving the opening to the tip corrects the dynamics of ejaculation.
• If notable curvature is present, correcting it — this can mechanically affect intercourse and, in turn, the chance of conceiving.
• If sperm parameters are low, evaluation by andrology and reproductive medicine.