Is testicular dysgenesis syndrome a genetic, endocrine, or environmental disease, or an unexplained reproductive disorder?

Testicular dysgenesis syndrome (TDS) development may be attributed to the following four key aspects: environmental exposure, genetic factors, intrauterine growth disorders, and lifestyle factors. These factors contribute to abnormal testis development in which disturbed Leydig cell differentiation and altered Sertoli cell differentiation are primary. Disturbed Leydig cell differentiation reduces insulin-like factor 3 (INSL3) and results in androgen insufficiency, and altered Sertoli cell differentiation leads to impaired germ cell function.170