Hi ! Good morning. I am Dr Shareef answering your query. Most of the time, this happens due to unnoticed repeated trivial injury to the testes even during normal day to day activities if the testes are not supported by properly fitting undergarments. If I were his doctor, I would advise him for a well fitting testicular support, some anti inflammatory, and a broad spectrum antibiotic if need be after sending a urine sample for routine and culture sensitivity test to rule out a urinary tract infection which could give rise to similar problem. If there was no relief, I would advise him for a Doppler ultrasound of both testes to rule out a chronic torsion of the testis. Further management would depend on the investigation reports. The sperm count could get affected in case of untreated infection of the urogenital system and also a condition called varicocele. So, it has to be ruled out by a physical examination of your fiance by a doctor. I hope this information would help him in discussing with his family physician/treating doctor in further management of his problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.