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The mumps virus can affect the testes in boys after puberty or in adult men.
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Most childhood diseases run their course, ending without significant long-term effects. However, this is not always the case with mumps, a common viral infection that affects the salivary glands in the jaw and upper neck. When mumps develops in a boy after puberty or an adult man, it sometimes causes testicular inflammation that can affect sperm production and lead to fertility problems.
Mumps is a viral infection first produces fever, headache, fatigue and muscle aches. Eventually, it causes inflammation of the salivary glands, located in deep tissues beneath the ears and in the upper neck. These glands become tender and noticeably swollen. One or both sides of the face may be affected. The symptoms of mumps generally last 7 to 10 days and usually disappear without lasting effects. Because it is caused by a virus, there is no specific treatment for mumps other than rest and time.
A vaccine against mumps has been available in the U.S. since 1967. Mumps vaccines are typically administered as part of a combined injection that prevents other childhood infections, such as measles or chickenpox. A combination of two sequential doses of the vaccine -- usually given at about 1 year and again at 4 to 6 years of age -- is 88 percent effective in preventing the mumps, according to the Centers for Disease Control and Prevention.
When a boy who's gone through puberty or an adult man contracts mumps, the disease sometimes affects the testes and causes an inflammatory condition called orchitis. According to a review published in 2006 in the "International Journal of Clinical Practice," orchitis develops with mumps in 20 to 30 percent of postpubertal males. The inflammation sometimes also involves the epididymis, a narrow tube that transports sperm out of the testis. Inflammation usually affects one testicle, but involves both testes in about 1 in 6 men with orchitis. Most cases of mumps-related orchitis develop during the first week of illness, causing painful swelling of the testicle and reddening of the scrotal skin. Pain usually resolves within a week. After the acute illness improves, the male might notice softening of the testicle under the scrotal skin, which may be followed by noticeable testicular shrinkage. This loss of testicular tissue occurs in 30 to 50 percent of males with mumps-induced orchitis.
In some cases of mumps-induced orchitis, the disease ultimately causes a reduction in sperm production. Although the reason for this is not thoroughly understood, a paper published in 2010 in the "British Journal of Urology International" reports that it might involve changes in male hormones during the early stages of orchitis. The researchers also indicate that the viral infection causes swelling that can increase pressure on the sperm-producing parts of the testis. Prolonged pressure may permanently damage the tissue, leaving it incapable of sperm production. The article notes that a reduction in sperm numbers in an ejaculate occurs in about 13 percent of men who have had mumps-related orchitis. Although this may lead to difficulty fathering a child, complete infertility is extremely rare.
Although most cases of mumps do not involve testicular inflammation, the "British Journal of Urology International" article notes that the occurrence of mumps and mumps-orchitis has been increasing worldwide. This may be due to vaccine shortages and other vaccine problems experienced in the 1990s, possibly explaining an increase in the problem among young men.
If you have had mumps-induced orchitis, the likelihood of having a fertility problem is reasonably low and permanent infertility is extremely unlikely. Nevertheless, if you have concerns about this possibility or are unsure if you have had the mumps vaccine, discuss these issues with your doctor.