You can check whether your baby’s testicles have descended by gently feeling the scrotum for two small, oval-shaped masses, each roughly the size of a pea in a newborn. If the scrotum feels soft and empty on one or both sides, the testicle on that side may not have descended yet. About 1 to 3 percent of full-term baby boys are born with at least one undescended testicle, and the rate is significantly higher in premature infants, ranging from 15 to 30 percent.
What a Normal Scrotum Looks and Feels Like
In most babies, the testicles complete their journey into the scrotum by the 33rd week of pregnancy. By birth, you should be able to see and feel both testicles sitting low in the scrotum. Each one feels like a small, firm, smooth oval that moves slightly under your fingertip. The two sides of the scrotum should look roughly symmetrical, though minor size differences are normal.
When one or both testicles haven’t descended, the affected side of the scrotum looks flatter or less full compared to the other side. If both are undescended, the entire scrotum may appear small and underdeveloped. The key sign is simple: you can’t see or feel a testicle in the scrotum on that side.
How to Check at Home
The environment matters more than you might expect. A warm room is important because cold air triggers a reflex that pulls the testicles up toward the body, which can make a normal testicle temporarily harder to find. Remove your baby’s diaper and pants completely, and let them warm up for a minute or two before checking.
Lay your baby on their back with their legs in a frog-leg position, knees bent and thighs spread apart. This position relaxes the muscle that controls testicular movement and keeps your hands from accidentally brushing the inner thigh, which can also trigger the pull-up reflex. With one hand, gently press the skin just above the groin downward toward the scrotum. In many cases, this alone will make the testicle visible. With your other hand, feel the scrotum to confirm the testicle is sitting there.
If you feel a small lump that you can gently guide down into the scrotum and it stays there on its own without tension, the testicle is in a normal position. If you can’t feel anything in the scrotum or groin area on one side, that testicle may be undescended.
Retractile Testicles vs. Undescended Testicles
It’s common for parents to feel a testicle one day and not the next. This often means the testicle is “retractile,” meaning it moves back and forth between the scrotum and the groin due to an overactive muscle reflex. Retractile testicles are not the same as undescended testicles. The key difference: a retractile testicle can be easily guided into the scrotum by hand and stays there without being held in place. An undescended testicle either cannot be felt at all or cannot be moved into the scrotum.
There’s also a less common situation called an ascending testicle. This is a testicle that was previously in the scrotum but has moved back up into the groin and can no longer be guided down easily. If you notice that a testicle you used to feel has disappeared and won’t come back down, that warrants a visit to your pediatrician.
The Spontaneous Descent Window
If your baby is born with an undescended testicle, there’s a good chance it will come down on its own. Most spontaneous descent happens within the first three months of life. After six months, it becomes unlikely that the testicle will descend without intervention. The prevalence of the condition drops from about 3 percent at birth to 1 percent by six months to one year, reflecting those cases that resolve naturally.
Pediatricians typically monitor the situation during routine well-baby checkups. If the testicle hasn’t descended by six months (adjusted for prematurity if your baby was born early), the American Urological Association recommends referral to a surgical specialist.
What Happens If a Testicle Stays Undescended
Testicles need to be in the scrotum because it’s cooler than the inside of the body, and that lower temperature is essential for normal sperm development later in life. An undescended testicle that stays in the abdomen or groin is also associated with a higher risk of testicular problems over time. Early surgical correction reduces these risks significantly.
The corrective surgery is called orchiopexy. It involves moving the testicle into the scrotum and securing it there. Current guidelines recommend completing the surgery by 18 months of age to preserve future fertility potential. While earlier is better, there are clear benefits to performing the procedure in any boy before puberty, even if it wasn’t done in infancy. The surgery is common, generally straightforward, and performed as an outpatient procedure, meaning your baby goes home the same day.
What to Look for at Each Stage
- At birth: Your pediatrician will check the scrotum as part of the newborn exam. You can also gently feel for both testicles during diaper changes in a warm room.
- First three months: If a testicle was absent at birth, check periodically during bath time or diaper changes when your baby is relaxed and warm. This is the window when most spontaneous descent occurs.
- By six months: If you still cannot feel the testicle in the scrotum, bring it up with your pediatrician. This is the point where referral to a specialist is recommended.
- Six to eighteen months: If surgery is needed, this is the ideal window. Correction by 18 months gives the best outcomes for long-term health.
Premature babies get extra time on this timeline. All age milestones are adjusted based on your baby’s original due date, not their actual birth date. A baby born two months early, for instance, would be evaluated at eight months of actual age rather than six.