Hypospadias: A birth defect that can contribute to infertility

Updated by the Progyny Clinical Team — August 2025.

Hypospadias is a birth (congenital) defect in which the opening of the urethra is on the underside of the penis. It can also present as incompletely developed foreskin and a bend or slight curve in the penis, even when it is fully erect.

It’s present in about one out of every 200 newborns with male reproductive organs.

How does hypospadias affect infertility if not surgically corrected?

• Since the urethra carries semen out of the body, the altered location of the opening can result in difficulties with ejaculation.
• Curvatures of the penis may make sexual intercourse difficult or painful.
• People with hypospadias are also more likely to be born with an undescended testicle, which can also decrease sperm count.

What causes hypospadias?

According to the Mayo Clinic, the cause of hypospadias is usually not known, but there are factors that may be linked to it:

• It’s more common in babies with a family history of the condition.
• Some gene changes may affect the hormones that guide genital development in a fetus with male reproductive anatomy.
• Some research suggests a higher risk when the birthing parent is over 35 years old.
• A possible link between hypospadias and a birthing parent’s exposure to certain hormones or compounds, such as pesticides or industrial chemicals, is being studied. More research is needed to confirm this.

How is it diagnosed?

Hypospadias is usually diagnosed soon after birth, through a physical exam by a pediatrician. If hypospadias is suspected, the doctor may order additional tests or imaging to evaluate the urinary tract, including the kidneys and bladder.

How is it treated?

Hypospadias is usually treated by surgery within the first year of life. Hypospadias surgery can include:

• Repositioning the urethra.
• Placing the urethra opening at the head of the penis.
• Reconstructing the skin around the opening.

Hypospadias surgery can also be done as an adult, though it is most often done in infants and young children. Some surgeries are easier than others, depending on the location of the urethral opening. Complications are more likely in adults, and can include:

• Bleeding
• Infection
• Narrowing of the urethra
• Curvature of the penis

How does hypospadias impact pregnancy?

Fertility problems from hypospadias should no longer remain after the hypospadias is surgically corrected. After surgery, the curve of the penis should be straightened, and proper forward ejaculation should be achieved.

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Disclaimer: The information provided by Progyny is for educational purposes only and is not medical advice. Always consult a qualified healthcare provider for medical guidance.