Anorchia: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 2, 2026.
What kind of doctor treats Anorchia?
A primary care doctor, such as a pediatrician or family doctor, is often the first to notice the problem and order early tests. From there, care usually involves an endocrinologist, who treats hormone problems, and a urologist, who treats conditions of the urinary tract and male reproductive organs. These specialists work together to plan treatment.
What it is
Anorchia is a rare condition in which a baby who is genetically male is born without one or both testicles. Testicles are the male reproductive glands that make sperm and testosterone. When both are missing, it is called bilateral anorchia; when only one is missing, unilateral anorchia. The condition is present from birth.
Symptoms
The main sign is that one or both testicles cannot be felt in the scrotum. If both are missing, a boy may go through puberty late or not at all, with less body and facial hair, a higher-pitched voice, and slower penis growth during the teen years.
Causes and who gets it
Doctors do not always know why anorchia happens. In some cases, the testicles formed normally during pregnancy but then stopped working or were reabsorbed before birth, sometimes because of a twist in the blood vessels that supply them. In other cases, they never formed at all. Anorchia is rare, is not usually inherited, and affects only people who are genetically male.
How doctors diagnose it
A doctor will first do a physical exam, then order blood tests measuring testosterone and other hormone signals from the brain. If levels suggest no working testicle tissue is present, imaging such as an ultrasound may be used. Genetic testing or a hormone stimulation test can sometimes help confirm the diagnosis.
Treatment
If both testicles are absent, doctors usually prescribe testosterone starting around the age puberty normally begins. It helps the body develop adult features such as a deeper voice, body hair, and muscle growth, and treatment is usually lifelong. If only one testicle is missing, treatment may not be needed, because the remaining testicle often makes enough hormones. Some people choose a prosthetic implant, and counseling can help with feelings about body image and fertility.
When to see a doctor
Parents should talk to a doctor if a baby boy's scrotum looks empty, or if a testicle that was felt before cannot be felt later. Any boy who has not started puberty by around age fourteen should also be checked. Early evaluation matters because hormone treatment works best when it starts at the right age.
Common questions
Can a man with anorchia have children?
Men missing both testicles usually cannot make sperm, so biological fatherhood is not possible without help such as donor sperm. Men missing only one testicle can often father children, because the remaining testicle may work normally.
Is anorchia the same as an undescended testicle?
No. An undescended testicle exists but has not moved down into the scrotum, and it can often be found or brought down with surgery. In anorchia, the testicle is truly absent, and tests can confirm the difference.
Can anorchia be prevented?
There is no known way to prevent it, because it happens before birth and the cause is often unknown. Good prenatal care supports a healthy pregnancy, but it does not stop this condition.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
