Abnormal sex determinism: True hermaphrodite (TH)

Abstract

Background: A True Hermaphrodite is defined as an individual with testicular and ovarian tissue either combined in a single gonad or found separately in two gonads. The birth of a child with ambiguous genitalia is an embarrassing and frightening experience for the families bearing social stigmata. This paper reports the psychologic, endocrinologic, cytogenetic and semen analysis data on a true hermaphrodite case. Case presentation: An 18 years old patient phenotypically appeared to be male with well-developed secondary characteristics, had two testicles in scrotum, a prostate like structure in proper ecoptern and two anatomical ovary-like masses in both sides of pelvis came to the Noor Clinic-Qom-IRAN in 2017. His karyotype was normal male (46,XY) and his levels of FSH, LH, Prolactin and Estradiol were within normal range of a male but hydroxy testosterone, DHEA and hydroxyl progesterone level were elevated. Semen analysis revealed he had low semen volume, 45% non-motile and 97% abnormal morphology sperms. Psychologically he assessed as an obsessive depressed person with a mild intellectual disability and female mannerisms with a strong desire toward gender reassignment to a female. Conclusion: Finally, hysterectomy and ovary resection performed.

Keywords

• Sex determination
• Ambiguous genitalia
• True hermaphrodite
• Case report