Fertility Preservation in an Adolescent with an Ovotesticular Disorder of Sexual Development
A 12-year-old boy was referred to pediatric surgery for correction of right unilateral cryptorchidism. The surgeon suspected the presence of testicular and ovarian tissue in the right gonad, and so the child was further referred to a pediatric endocrinologist to investigate a disorder of sexual development (DSD). A biopsy was performed that revealed numerous primordial follicles and some primary and secondary follicles, surrounded by ovarian stroma and testicular parenchyma, with seminiferous tubules displaying Sertoli and germinal cells. Focal spermatogenesis was present as well as testicular stroma with focal Leydig cells. The patient had a male phenotype with a small penis with a slight ventral curve and a palpable, homogeneous, approximately 2 cc gonad in the left scrotum. The patient had been referred to another department in early childhood for correction of urogenital abnormalities, but no investigation or intervention was undertaken at that time.
KeywordsFertility preservation Cryptorchidism Gonad Urogenital abnormalities Testosterone therapy