Modern testicular transplantation
As mentioned in a previous chapter, at the beginning of the twentieth century testicular transplants were widely used with the aim of combating the ageing process. At the time there was absolutely no knowledge of the factors determining the ageing process and loss of potency. Attention turned to the testicles: testicular tissue, either human or animal in origin, was transplanted, mostly in sections, into the scrotum. Remarkable results were reported for a broad spectrum of ailments, though the research results were rather coloured by personal motives. The ensuing polemics damaged the development of endocrinology, the science of hormones. That was even more the case with the commercial exploitation of this irrational treatment. In 1935 testosterone was isolated, so that testicular transplants fell temporarily out of fashion.
Due to new technical capabilities in the surgical field new interest was awakened in testicular transplants in the 1960s. Experiments focused on rats and dogs and eventually led to the transplantation of an individual’s own material, in particular with baby boys who had extreme forms of undescended testicles. Transplantation from one human being to another was initially carried out only in the then virtually inaccessible Soviet Union; virtually nothing reached the outside world. In the 1970s a publication appeared on a successful testicular transplant in a pair of monozygotic twins, one of whom had no testicles and the other two. Inspired by this, two Chinese research teams began a test transplant in human beings. Despite the limitations due to the suppression of rejection in the recipient, remarkably good results were achieved, and a report appeared on the first two children fathered with a transplanted testicle. In the view of the researchers testicular transplantation could be of crucial importance for, for instance, anorchid men (literally without testicles), a condition affecting one in 20,000 men. Anorchidy is not life-threatening but if untreated it leads to a loss of l ibido, psychological problems, premature ageing symptoms and accelerated loss of bone mass. A select group of men with fertility problems might also benefit from testicular transplantation. It could be used for couples who choose the possibility of having a child independently over new techniques of reproduction and for whom the disadvantages are outweighed by the above-mentioned advantages. Of course female-to-male transsexuals would be eligible for testicle transplantation, though as yet no transplantations from one man to another have yet been carried out. Quite apart from the ethical aspects, it is the side-effects of the medication required after surgery which are the main obstacle to the procedure.