Delhi man undergoing infertility test discovers he has uterus
What's the story
A 26-year-old man in Delhi was found to have a uterus after undergoing infertility tests at RG Hospitals, Rajouri Garden. The patient, who had been living as a male and displayed typical male characteristics, had approached Dr. Susheel Kharbanda for help with his infertility issues. During the examination, doctors noticed both testes were absent from the scrotum and semen analysis revealed azoospermia (no sperm).
Genetic findings
Shocking discovery
Further investigations, including chromosome testing and imaging, were conducted.
The chromosome test revealed an XY male pattern, but ultrasound and MRI scans showed the presence of a well-formed uterus and fallopian-tube-like structures inside his body.
Both testes were found inside the body, resembling ovaries in appearance.
Dr. Kharbanda described this discovery as "shocking" and said both testicles looked like ovaries.
"And both testicles, they were just like ovaries as they are in females," India Today quoted the doctor as saying.
Medical anomaly
What is Persistent Mllerian Duct Syndrome (PMDS)?
Dr. Chirag Bhandari, Founder of IASH Institute of Andrology and Sexual Health, an Andrologist and Male Reproductive Health Specialist, explained that this condition is known as Persistent Müllerian Duct Syndrome (PMDS).
PMDS is a rare disorder where Müllerian structures such as the uterus remain present in individuals with male chromosomes and external genitalia.
Dr. Bhandari explained that during normal male development, these ducts regress due to anti-Mullerian hormone (AMH) produced by testes.
Health implications
Infertility may arise from various issues
The presence of undescended testes can impact fertility since sperm production requires lower temperatures than the body's core temperature.
Infertility may also arise from anatomical, hormonal, genetic, or developmental issues.
"In certain instances of PMDS, the testicles may be found in a wrong location, such as in the abdomen or the inguinal canal rather than the scrotum," he said.
He said the medical team decided to remove both the uterus and testes laparoscopically due to potential cancer risks.
Post-surgery findings
Biopsy showed minimal signs of malignancy
After removal, a biopsy was done on the tissue, which showed minimal signs of malignancy. Dr. Kharbanda said it was important to remove the undescended testes because leaving them inside the abdomen could increase the risk of cancer developing.
"It's good we removed those. If we have not removed them, in the future, you might develop cancer in those testicles," he said.