Man born without testicle gets one from identical twin brother so he can have children of his own
After the surgery, the man's testosterone levels reached the normal range and his testicles will now carry sperm, say doctors. He can father children — but through in vitro fertilization for now
A 36-year-old Siberian man born without testicles can now father children, thanks to his identical twin brother who donated one of his testicles, according to an international team of surgeons.
The man is now the third person known to have undergone a testicular transplantation surgery, which lasted six hours.
"He's good, he looks good, his brother looks good," Dr. Dicken Ko, a transplant surgeon and urology professor at Tufts University School of Medicine in Boston, who flew to Belgrade to help with the procedure told The New York Times.
The donor, who already has children, should remain as fertile as he was before, despite giving up a testicle, according to the surgeon.
The Siberian man was born without testicles — a rare condition. As a result, he could not produce sperm and the male hormone testosterone.
Testicular transplantation offers a ray of hope to other people as well, including transgender people, accident victims, wounded soldiers, and cancer patients.
This form of transplantation is not the most opted procedure. Generally, people who lose their testicles opt to take testosterone to replace the hormones and receive testicular prostheses to restore the appearance.
The Siberian sibling chose surgery over hormone replacements. The surgery was intended to give the recipient more stable levels of the male hormone testosterone than injections could provide, to make his genitals more natural and more comfortable and enable him to father children, says Dr. Ko.
The doctors do not expect any complications arising from the surgery. The success of transplantation among twins is high, as they share similar genetic makeup, meaning they have almost identical tissues in their bodies, say medical experts.
However, the procedure did not come without its share of challenges. The surgeons had to be swift and precise. "Once you remove the testicle from the donor, the clock starts ticking very fast," Dr. Branko Bojovic, an expert in microsurgery at Harvard Medical School and part of the team in Belgrade told the New York Times.
"If they do not act fast, the testicle will lose its viability — a testicle is viable for only four to six hours," he adds.
After the surgery, the Siberian man's testosterone levels reached the normal range and his testicles will now carry sperm, say doctors. He can father children — but he won't be able to reproduce sexually, for now.
This is because doctors could not connect a structure called the vas deferens, which carries the sperm out of the testicles. However, the team says, another operation can fix this in the future.
In the meantime, however, he could undergo in vitro fertilization, where his sperm can be harvested and used to fertilize embryos, say doctors.
In the future, transplantation could find use among people wanting to undergo female-to-male sex reassignment, says the team. Doctors throw away the penis and testicles, after male-to-female reassignment surgery.
Instead, the team argues that these discarded organs could be used for transplants. "We have to do this as soon as possible, to stop putting healthy organs in the garbage," says Dr. Miroslav Djordjevic, the lead surgeon.