During the development of the male fetus, about a month or two before the baby is born, the testicles drop down into the scrotum. However, in about 1 case in 20, one of the testicles doesn’t complete this journey when the baby is still in the womb. Sometimes both testicles can be affected. Usually, after a month or two, the missing ball will plop down into the scrotum of its own accord. If it a testicle doesn’t descend completely, it can be corrected with surgery. If it doesn’t descend at all, the boy can grow up with only a single visible testicle and live a normal life.
There’s a reason why testicles hang outside body in a little bag called the scrotum: it’s to keep them cooler than body temperature, which is what they need to produce sperm.
So if one of the testicles doesn’t descend, it would be logical to think it would be too hot to make sperm. Does that make men with monorchism infertile? Some say no. Experts suggest that a single testicle can churn out enough sperm all on its own to get a woman pregnant. But this is a controversial, because other experts do say that monorchism can lead to infertility.
Having just one testicle doesn’t make you less ‘macho’ or more ‘feminine’ in terms of all the standard clichés. One testicle is enough to produce enough hormones for a guy to exhibit those testosterone-fueled ‘masculine’ traits.
In most cases, having a single testicle isn't a huge problem. But that doesn’t mean you can’t do anything about it. Especially people who have had a testicle removed due to cancer sometimes opt for a testicular implant. These false testicles can cause complications though – implants filled with silicone gel can leak, just like breast implants. Another option is an implant filled with saline solution – and some guys even have stainless steel or titanium balls!
Having a single testicle is among the risk factors for developing testicular cancer. While for normal males, only 1 in 10,000 is likely to develop it, among men with monorchism the risk goes up to roughly 1 in 2000. This is why many experts have now begun to suggest it’s a good idea to have corrective surgery at an early age.
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