Unilateral polyorchidism with severe male infertility: a case report

Abstract

Polyorchidism is an uncommon congenital condition often discovered incidentally, which may significantly impact male fertility. We present a case of a 34-year-old man with unilateral polyorchidism and associated severe asthenozoospermia and teratozoospermia. Despite normal hormonal levels and no detected genetic anomalies, the patient's sperm showed mitochondrial damage, and his fertility remained compromised after conservative management and assisted reproductive attempts. This case underscores the intricate relationship between polyorchidism and male infertility, highlighting the need for personalized management strategies and further research into its etiology and impact.

Keywords: Asthenozoospermia; Male infertility; Mitochondrial damage; Polyorchidism; Semen analysis; Teratozoospermia.

Fig. 1

Testicular color Doppler ultrasound images and schematic representation. (A) Right testicle. (B) Left testicle with two small testicles. (C) Schematic representation of the left spermatic path

Fig. 2

Transmission electron microscopic observation of sperm ultrastructure. (A) Decreased mitochondrial number and disordered arrangement. (B) Dissolution of the acrosome; decreased mitochondrial number, disordered arrangement, swollen cristae of the mitochondria. (C) Decreased mitochondrial number. (D) Granular changes in the sperm nucleus with increased and enlarged nuclear pores

Fig. 3

Illustration of the AZF region on the Y chromosome of Patient Y