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Review
. 2015 Dec;44(4):705-22.
doi: 10.1016/j.ecl.2015.07.009. Epub 2015 Sep 1.

Infertility and Reproductive Function in Patients with Congenital Adrenal Hyperplasia: Pathophysiology, Advances in Management, and Recent Outcomes

Oksana Lekarev  1 , Karen Lin-Su  1 , Maria G Vogiatzi  2
Affiliations
Review

Infertility and Reproductive Function in Patients with Congenital Adrenal Hyperplasia: Pathophysiology, Advances in Management, and Recent Outcomes

Oksana Lekarev et al. Endocrinol Metab Clin North Am. 2015 Dec.

Abstract

Individuals with congenital adrenal hyperplasia have reduced fertility. However, reproductive outcomes have improved over the years. This review provides an update on the multiple pathologic processes that contribute to reduced fertility in both sexes, from alterations of the hypothalamic-pituitary-gonadal axis to the direct effect on gonadal function by elevated circulating adrenal androgens. In addition, elevated serum progesterone concentrations may hinder ovulation and embryo implantation in women, whereas in men testicular adrenal rest tumors can be a major cause of infertility. Suppression of adrenal androgen secretion represents the first line of therapy toward spontaneous conception in both sexes.

Keywords: 21-Hydroxylase deficiency; Congenital adrenal hyperplasia; Fertility; Pregnancy; Testicular adrenal rest tumors (TART).

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