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Living with 46,XX ovotesticular disorder of sex development

A rare difference of sex development in which a person has both ovarian and testicular tissue, with a 46,XX chromosome pattern.

Understanding 46,XX ovotesticular disorder of sex development

46,XX ovotesticular disorder of sex development is a rare condition with both testicular and ovarian tissue in a person with 46,XX chromosomes.

The tissue is confirmed under a microscope. Features vary and can include genitals that are not clearly male or female, hypospadias, undescended testes, and polycystic ovaries. Fertility may be lower. GARD lists onset as a variety of ages.

Signs & symptoms

Symptoms vary from person to person. GARD lists these among the most common:

  • Genitals that are not clearly male or female
  • Hypospadias
  • Undescended testes (cryptorchidism)
  • Small scrotum or small penis
  • Polycystic ovaries
  • Lower fertility

Not everyone has every symptom. GARD's list comes from the Human Phenotype Ontology.

Diagnosis

  1. Talk with your doctor

    Share the symptoms you've noticed, when they started and your family health history. Notes and photos can help.

  2. See a specialist

    Specialists who may be involved include genetic specialists, hormone specialists, maternal-fetal medicine specialists and urinary and male reproductive system specialists.

  3. Ask which tests can help

    Your care team will decide which exams and tests can confirm the diagnosis.

  4. Connect with expert centers

    Resolve: The National Infertility Association may keep lists of experts for this condition.

Care & treatment

Care team
Genetic specialists (geneticists); Hormone specialists (endocrinologists); Maternal-fetal medicine specialists (pregnancy-related); Urinary and male reproductive system specialists (urologists)
Expert care
Expert lists: Resolve: The National Infertility Association
Treatment
GARD doesn't list specific treatments for this condition. Your care team will tailor care to your symptoms.
Research
Clinical trials and observational studies may be options. See the research section below.

General information, not medical advice. Your care team makes the decisions.

Everyday life

Living with a rare condition is easier with support.

  • Connect with Resolve: The National Infertility Association
  • Keep notes on symptoms, changes and questions for appointments
  • Ask about patient registries that help research
  • Look into financial aid and travel resources for care visits
Bring these questions to your next doctor visit
Which specialists should be on our care team?
What do the tests of the gonads show?
What should we know about fertility and hormones?

Quick facts

Symptoms usually starta variety of ages
InheritanceAutosomal Dominant, Autosomal Recessive

GARD says changes in genes (also called variants) cause this condition. It is listed as autosomal dominant or autosomal recessive.

GeneticEndocrineUrinary and Reproductive

Also known as: 46,xx ovotesticular dsd; ovotesticular differences of sex development; ovotesticular disorders of sex development; ovotesticular dsd

Patient organizations

Broader rare-disease groups

Source: NIH GARD · 46,XX ovotesticular disorder of sex developmentGARD ID 16585 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

You are more than your diagnosis

Perspectives from people navigating life with 46,XX ovotesticular disorder of sex development.

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