A 24-year-old man goes for an infertility test in Delhi and discovers he has a uterus
A routine infertility evaluation led to an unexpected medical discovery when a man in his 20s was reportedly found to have a uterus and structures resembling fallopian tubes inside his body. According to news reports, the man was undergoing investigations after experiencing infertility and was found to have azoospermia, a condition in which there is no sperm in the semen. Doctors also found that both his testes were undescended.
Further investigations revealed the presence of Mllerian structures, including a uterus. Doctors diagnosed him with Persistent Mllerian Duct Syndrome (PMDS), a rare congenital condition in which Mllerian structures remain present in a person who has typically male physical development.
The unusual case highlights how certain reproductive and developmental conditions can remain hidden for years and may only be discovered when a person undergoes medical investigations for infertility.WHAT IS PERSISTENT MLLERIAN DUCT SYNDROME?
Explaining the condition, Dr Chirag Bhandari, Andrologist and Male Reproductive Health Specialist and Founder of IASH Institute of Andrology and Sexual Health, said PMDS is a rare condition in which Mllerian structures remain present in genetically male individuals.
"In this case, a key factor is Persistent Mllerian Duct Syndrome. PMDS is a rare form of sexual development disorder, in which Mllerian structures remain present in genetically male persons," he said.
During typical male embryonic development, the Mllerian ducts regress because of anti-Mllerian hormone, or AMH, produced by the testes. However, if AMH is not produced adequately or the body does not respond properly to the hormone, these structures may persist.
Dr Bhandari explained that a person with PMDS can have normal male external genitalia despite having a uterus internally.
"This is called Persistent Mllerian Duct Syndrome, which means that the uterus is still present inside the man while he has normal external genitalia, like testes and penis. So, this is a very rare condition," he said.WHY CAN PMDS AFFECT FERTILITY?
One of the major concerns in such cases is fertility. The presence of undescended testes can affect sperm production because the testes normally need a temperature lower than the body's core temperature for healthy sperm production.
"In certain instances of PMDS, the testicles may be found in a wrong location, such as in the abdomen or the inguinal canal rather than the scrotum," Dr Bhandari said.
He added that an undescended testicle can affect sperm production because sperm cells develop best at lower temperatures than those found inside the abdomen.
However, having PMDS does not automatically mean that a person cannot have biological children. Fertility depends on factors such as testicular function, sperm production and whether sperm can be retrieved from the testes.
"If the man has functioning testes, which means that the testicular volume and size are normal and there is sperm in the ejaculate, he can conceive naturally," Dr Bhandari said.TREATMENT DEPENDS ON SPERM AND TESTICULAR FUNCTION
For men who do not have sperm in their semen, doctors may investigate whether sperm can be retrieved directly from the testes. Depending on the findings, assisted reproductive techniques such as IVF or ICSI may be considered.
Dr Bhandari said that in some cases, the testes may be located in the abdomen and may not have adequate function. If viable sperm cannot be obtained, donor sperm may also be considered as a fertility option.
He stressed that male infertility should not be assessed only through a sperm count. Problems with reproductive anatomy, hormones, genetics or development can also play an important role.A RARE CONDITION THAT MAY GO UNDETECTED
According to Dr Bhandari, only a few hundred cases of PMDS have been described in medical literature, making it an extremely rare condition.
The discovery of a uterus in a person raised and identified as male can understandably be surprising, but the finding itself does not determine a person's gender identity or automatically indicate their fertility potential.
"In this case, the presence of a uterus should not be merely seen as a strange event. It obligates andrology, reproductive endocrinology, and, if necessary, genetics specialists to examine the patient," Dr Bhandari said.
He added that doctors need to assess the person's anatomy, hormonal status, testicular function and sperm availability before deciding on treatment.
PMDS is therefore a condition that requires individual assessment rather than assumptions based on physical appearance alone. For patients who discover the condition during an infertility evaluation, a detailed assessment can help doctors understand the underlying reproductive anatomy and determine what fertility options may be possible.- EndsPublished By: Smarica PantPublished On: Sep 11, 2026 10:08 IST
