Ask the Doctor: Can a man with no testicles have children?

I know it is normal for a man to have two testes. However, although I have none, I have nine children; three girls and six boys. Is this possible? M

Dear M, 

Testes are formed in the abdomen from where they migrate and appear in the scrotum of a baby boy.

Sometimes, one or both testes may not be found in the scrotum at birth because they may have been held up along their path from the abdomen (undescended testicles, Cryptorchidism). In this case, they may be found located in the abdomen or groin rather than the scrotum. 

In Cryptorchidism, the testicles are more likely to get injured, get cancer or testicular torsion leading to their death or that of the victims apart from infertility.

The testes have to be put back in the scrotum at a young age to improve one’s chances of fertility even if the fertility may not be 100 percent.

Other times, a boy may be born without testes, (anorchia) and in this case, the testes have died. Here, if the testicular loss occurs early in pregnancy, the boy may be born with female sexual parts.

If the loss happens later, treatment using male hormone and putting artificial testes may help one to not only properly develop into a boy but also get some self-esteem regardless of the fact that the victim will not be able to have children.

Retractile testes are those that keep moving in and out of the scrotum and these, which are not usually associated with infertility, may be mistaken for undescended testes or even absent testicles.

Testes help a man produce male hormones which are key in causing erections and a male stature, among others. Testes also provide sperms for fathering children.

Without them, therefore, a man will be unable to have children. Therefore, you should take the children for DNA paternity tests to find out whether they are yours or not.

How can I get rid of love handles?

I am overweight and have what my former classmates used to refer to as perilli on my body. I cannot even wear tight clothes. What can I do to get rid of them? Sandi

Dear Sandi,

What they call perilli are the so-called “Love handles” which are folds of skin usually in obese people due to accumulation of excess fat around the hips and abdominal area.

Unfortunately, tight clothing which are trendy today, might make them more prominent, the reason you should avoid wearing them.

Although you are more worried of the cosmetic issues, love handles may put you at risk of suffering from medical problems such as high blood pressure (hypertension), heart disease, sleep apnoea (obstruction of breathing leading to snoring), stroke, type 2 diabetes, cancer especially of the colon (big intestine) or breast, apart from wear and tear joint problems (osteoarthritis). Fortunately, prevention or treating love handles may help prevent the hidden risks of the said health problems. 

Prevention or treatment may include managing stress, avoiding or regulating eating foods high in fats or too much sugar, engaging in physical exercise, having enough sleep and treating disease conditions that may cause love handles, including a thyroid gland not producing enough thyroid hormones (hypothyroidism).

Surgery referred to as liposuction can be done as a last resort in case the above measures do not help prevent or take away the handles.

What can I do to gain some weight?

I am a 29-year-old woman who despite doctor’s advice to eat fatty foods or get pregnant, I still weigh only 60kgs. My seven brothers and sisters gain weight easily. What can I do? Amina

Dear Amina,

Whereas you think it is diet and genetics alone that determine body size, other factors, including age, sex, lack of or exercising too much and use of drugs, among others may determine a person’s body size.

Some people can eat fried foods and junk often and not exercise at all but may still not gain any weight. Others may exercise excessively and miss meals but still fail to lose weight.

It is likely that you want to gain weight just as a cosmetic rather than a health measure. At 60kgs, your weight, when compared to your height, could still be healthy. Please check your height as well so that we can assess your healthy weight well using a Body Mass Index (BMI).

A healthy BMI, a measure of body fat based on height and weight, at 60kgs is between 1.56m -1.75m for adult men and women.

If your BMI is as I indicated, your weight is healthy. Trying to gain more weight, even when you are small may still put you at risk of some disease conditions caused by too much cholesterol in the blood, including heart disease and stroke.

Healthy weight is achieved by exercising regularly, minimising stress and avoiding lifestyle factors that may raise one’s cholesterol. One must also stop smoking, drinking too much alcohol and taking too much fatty foods and junk.

Many women gain weight during pregnancy (due to a growing baby, storing fat and holding more water among others). However, when a woman delivers, depending on many factors, she may still lose this gained weight as could have happened to you.