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Hello, I am Prof. Dr. Volkan İzol.

One of the most common concerns expressed by parents who come to my clinic is this:

“Doctor, my son was born with only one testicle. Is this normal? Will he have any problems later on?”

This is a very valid concern. The testicles are very important for both reproduction and hormone production. However, being born with only one testicle does not always mean there is a serious health problem.

In this article, I will discuss the condition of being born with a single testicle (monorchism), its causes, symptoms, diagnosis and treatment process, how it affects a person’s future life, and every detail families need to know.

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The testicles are two small organs located inside a sac called the scrotum.

Responsibilities:

•Sperm Production: Enables men to become fathers in the future

•Testosterone Secretion: The male hormone is responsible for voice deepening, muscle development, and sexual function during puberty

For this reason, the absence or underdevelopment of the testes can, in some cases, affect hormonal and reproductive functions.

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This condition is called congenital monorchism.

•Sometimes the testis fails to develop (agenesis)

•Sometimes it develops but remains inside the abdomen (undescended testicle)

•Sometimes it twists and disappears during pregnancy

What is important is to properly assess and monitor this situation.

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Parents usually notice it at birth:

•One side of the scrotum is empty

•The other testicle may be normal in size or slightly larger

Symptoms in later life:

•Scrotal asymmetry

•Signs of hormone deficiency during adolescence (rare)

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•Developmental Deficiency: The testis fails to develop during the embryonic period

•Undescended Testicle: It has not descended into the scrotum at birth; it remains in the groin or inside the abdomen

•Torsion in the Womb: The testicle disappears because it has twisted, cutting off blood flow

•Hormonal Problems: Hormone Deficiency During Pregnancy

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The child should be evaluated by a pediatric urologist.

•Physical Examination: The inguinal canal and scrotum are carefully examined

•Ultrasound: This test checks whether the testicles are in the groin or have not developed at all

•MRI: The intra-abdominal testis is examined

•Laparoscopy: A camera is used to examine the abdominal cavity to confirm the presence of a testicle

At my clinic, I use laparoscopy for both diagnostic and therapeutic purposes, particularly in children with a missing testicle on one side.

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1️⃣ If There Is an Undescended Testicle

It is repositioned surgically (orchidopexy).

•Best time: 6–12 months

•Early intervention is very important for both sperm production and reducing the risk of cancer

2️⃣ If There Are No Testicles at All

•If the other testicle is functioning normally, treatment is usually not necessary

•A testicular prosthesis may be implanted for cosmetic purposes during adolescence

3️⃣ Hormone Therapy

In some cases, hormone-stimulating therapy (hCG) can be used to induce testicular descent.

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Many families ask:

“Doctor, can I have a child with only one testicle?”

My answer: Yes. A single testicle usually produces enough sperm and testosterone.

Development proceeds normally during adolescence.

However, here are some things to keep in mind:

•Protecting the other testicle from injury

•Regular urological checkups

•Monitoring hormone levels during adolescence

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•If a testicle has not descended, the risk of cancer increases later in life

•Hormonal insufficiency is rarely seen

•There may be psychological effects (self-confidence issues)

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After orchiopexy:

•The child is usually discharged the same day

•Will return to normal activities within 1–2 weeks

•Follow-up with an annual checkup

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For families of children born with only one testicle, the biggest concern is their future sexual life and the possibility of fatherhood.

I emphasize the following to families:

“It is possible to lead a healthy life with only one testicle. Hormone production is usually sufficient during adolescence and adulthood.”

If necessary, I support self-confidence by recommending cosmetic testicular prostheses during adolescence.

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Is it possible to have a normal sex life with only one testicle?

Yes, it is completely normal as long as hormone production is sufficient.

Will she be able to have children in the future?

Yes, a single testicle usually produces enough sperm.

What should I do to protect my other testicle?

You should wear protective gear when playing sports and avoid injuries.

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In my practice, every child born with a single testicle undergoes a thorough examination.

The presence of the testis is confirmed by laparoscopy.

If there is no testicle, I inform the family and develop a long-term follow-up plan.

The goal is for the child to grow up healthy, both physically and psychologically.

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Although being born with only one testicle may seem concerning, it usually does not pose a serious problem.

With timely diagnosis and surgery if necessary, the child will grow up completely healthy and go through a normal adolescence and adulthood.

As Prof. Dr. Volkan İzol, my goal is to ensure that these children receive the best possible care—both medically and psychologically—and to educate their families.