24-Year-Old Man in Delhi Found With Uterus and Undescended Testes During Infertility Test

A 24-year-old man who visited a Delhi hospital for an infertility evaluation was reportedly found to have a fully developed uterus inside his body along with both testes located in the abdomen. The unusual discovery was made after doctors investigated the absence of sperm in his semen and found that both testes were missing from the scrotum.

The man had been living as a male and had typical male physical characteristics. He reportedly had no obvious symptoms indicating an underlying reproductive abnormality and sought medical attention specifically because of infertility.

During the initial examination, doctors found that neither testis was present in the scrotum. A semen analysis also showed no sperm, a condition medically known as azoospermia. These findings led doctors to conduct further investigations, including chromosome analysis, hormonal testing and detailed imaging.

Chromosomal testing showed an XY pattern typically associated with males. However, ultrasound and MRI scans revealed the unexpected presence of a well-formed uterus inside the body. The scans also showed that both testes were located internally rather than in the scrotum.

Doctors identified the unusual anatomy as being consistent with Persistent Müllerian Duct Syndrome, or PMDS, a rare disorder of sexual development. The condition can occur in people with male chromosomes and typically male external genitalia when Müllerian structures, such as the uterus and sometimes fallopian tubes, remain inside the body.

During typical male development, the Müllerian ducts regress under the influence of anti-Müllerian hormone, or AMH, produced by the testes. PMDS can occur when AMH is not produced adequately or when the body does not respond properly to the hormone, allowing these structures to persist.

The condition can also be associated with undescended testes. This can affect fertility because normal sperm production requires the testes to remain at a temperature lower than the body's core temperature. When the testes remain inside the abdomen or another abnormal location, sperm production may be impaired.

However, PMDS does not automatically mean that a person is permanently infertile. Fertility depends on factors including the condition and function of the testes and whether viable sperm are being produced. In some cases, doctors may attempt to retrieve sperm directly from the testes if none is found in the semen. Depending on the results, assisted reproductive procedures such as IVF or ICSI may also be considered.

In this case, doctors decided to remove the uterus and both internally located testes through laparoscopic surgery, a minimally invasive procedure. The removed tissue was subsequently sent for biopsy.

The decision to remove the undescended testes was linked to concerns about their location and the potential long-term risk of cancer. Testes that remain undescended, particularly inside the abdomen, can carry an increased risk of developing testicular cancer.

The biopsy reportedly showed only minimal signs of malignancy. Doctors said removing the internally located testes was considered important to reduce the potential future cancer risk.

Specialists describe PMDS as an extremely rare condition, with only a few hundred cases reported in medical literature. Because the condition can remain undetected for years, it may sometimes only come to light during investigations for infertility or undescended testes.

Experts stress that the discovery of a uterus in someone who has been raised and identified as male should not simply be regarded as an unusual anatomical curiosity. Such cases require comprehensive assessment involving specialists in andrology, reproductive endocrinology and, where appropriate, genetics.

The case also highlights the importance of detailed evaluation in men experiencing unexplained infertility or azoospermia. Depending on the circumstances, doctors may use physical examinations, imaging, hormonal testing and genetic investigations to identify developmental or anatomical conditions that may otherwise remain undiagnosed.