Having only one testicle, known medically as monorchism, can sometimes affect testosterone levels and fertility but does not always. There are several key points to understand:
- The testicles are responsible for producing the male sex hormone testosterone. Each testicle contains many seminiferous tubules that produce sperm and Leydig cells that produce testosterone.
- Typically, having two testicles helps provide backup and ensures normal testosterone levels. However, one healthy testicle can usually produce enough testosterone and sperm for normal hormonal function and fertility.
- Testosterone levels are highly variable and a single testicle can often compensate to produce near-normal testosterone levels. Multiple factors impact testosterone, including genetics, age, stress levels, medications, chronic disease, etc.
- Reasons for losing a testicle include:
- Testicular cancer - Most common in men 15-35 years old
- Injury
- Undescended testicle
- Testicular torsion
- Infection like epididymitis or orchitis
- Congenital defect (born with one testicle)
- Effects of monorchism depend on different factors:
- Age at which testicle was lost - Losing it young leads to better compensation
- Reason for loss - Cancer more impactful than injury or undescended
- Remaining testicle health - Must be normal for proper function
- Genetics and natural testosterone levels
- Having one testicle can increase risk of infertility since less sperm is produced. Just as normal variation in testicle size occurs, compensation abilities can vary.
- If monorchism does lead to chronically low testosterone or infertility, there are treatment options:
- Testosterone replacement therapy - Tablets, patches, gels
- Surgery - Testicular prosthesis
- Fertility treatments - ICSI, donor sperm
In summary, while monorchism may not impact testosterone or fertility for many men, frequent monitoring of testosterone levels and semen analysis when trying to conceive are recommended if issues emerge. Support from an endocrinologist, urologist fertilty specialist is key for diagnosis and management.
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