Do men without testicles (orchiectomy) still produce semen?

Men Without Testicles Produce Limited or No Semen

Men who have undergone bilateral orchiectomy (removal of both testicles) will produce very little or no semen, as testicles are essential for both sperm production and significant components of seminal fluid.

Components of Semen and Their Sources

• Semen consists of multiple components from different reproductive organs:
  • Sperm cells (spermatozoa) - produced exclusively in the testicles 1
  • Seminal fluid - produced by several accessory glands:
    • Seminal vesicles - contribute approximately 70% of seminal fluid volume 1
    • Prostate gland - contributes about 25% of seminal fluid 1
    • Bulbourethral glands - contribute a small amount of pre-ejaculatory fluid 1

Effects of Bilateral Orchiectomy on Semen

• Complete absence of sperm cells (azoospermia) - With no testicles, sperm production is impossible 1
• Significantly reduced semen volume - While some fluid may still be produced by the prostate and seminal vesicles, the volume will be markedly decreased 1
• Altered biochemical composition - The absence of testicular contributions changes the composition of any remaining seminal fluid 1

Clinical Considerations

• Men with bilateral orchiectomy will have:

  • Azoospermia (complete absence of sperm in ejaculate) 1
  • Reduced ejaculate volume 1
  • Changes in ejaculate consistency and appearance 1
  • Hormonal changes including decreased testosterone unless replacement therapy is provided 2

• Even with unilateral orchiectomy (removal of one testicle), studies show:

  • Decreased sperm concentration in many cases 2
  • Potential for azoospermia in some patients (9% in one study) 2
  • Altered hormonal profiles with increased FSH and decreased inhibin B 2

Special Considerations

• Men with testicular cancer often have abnormal semen parameters even before orchiectomy 3
• Men with a history of cryptorchidism (undescended testicles) who undergo orchiectomy may already have compromised fertility 4, 5
• Hormonal replacement therapy after bilateral orchiectomy can maintain secondary sexual characteristics but cannot restore sperm production 2

Clinical Implications

• Men facing bilateral orchiectomy who wish to preserve fertility should be counseled about sperm banking before surgery 2
• Some studies suggest that the optimal time for sperm cryopreservation is before orchiectomy rather than after, as semen quality often deteriorates following the procedure 2
• Men with bilateral orchiectomy will require testosterone replacement therapy to maintain secondary sexual characteristics and prevent symptoms of hypogonadism 2