Document Detail


Fertility among women with classical congenital adrenal hyperplasia: report of seven cases where treatment was started after 9 years of age.
MedLine Citation:
PMID:  18569031     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIM: Androgen excess is believed to be one of the major factors responsible for poor fertility outcomes in females with congenital adrenal hyperplasia (CAH). Some believe that the adverse effect of androgens on fertility could have its origins as early as the antenatal years. To assess the impact of prolonged androgen exposure on fertility in CAH patients, we compiled the data of females with CAH followed in our clinic during the last 25 years who were sexually active and had not been initiated on steroids until age 9 years. STUDY DESIGN AND PATIENTS: This was an observational case study on seven patients with classical CAH who fulfilled the inclusion criteria. The age at initiation of therapy in these females ranged from 9 years to 29 years. RESULTS: All patients had varying degrees of genital ambiguity. The most common presenting complaints were genital ambiguity, non-development of secondary sexual characteristics, hirsutism and primary amenorrhea. Genital surgery was performed in all patients at ages ranging from 12 to 29 years, except for one patient who underwent surgery at age 5 years without a diagnosis of CAH being made. Breast development ensued within 2 to 12 months and periods started in all patients within 2-24 months of steroid initiation. There were 13 pregnancies (seven normal vaginal deliveries, two spontaneous abortions and four pregnancies were medically terminated). CONCLUSIONS: Late initiation of steroid therapy did not affect fertility in our cohort of CAH women. Androgen excess in situations of subnormal cortisol may not adversely affect fertility in females with CAH.
Authors:
Bindu Kulshreshtha; Eunice Marumudi; Madan Lal Khurana; Alka Kriplani; Geeta Kinra; Denvender K Gupta; Kiran Kucheria; Rajesh Khadgawat; Nandita Gupta; Ashu Seith; Ariachery C Ammini
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology     Volume:  24     ISSN:  1473-0766     ISO Abbreviation:  Gynecol. Endocrinol.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-06-23     Completed Date:  2008-09-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807913     Medline TA:  Gynecol Endocrinol     Country:  England    
Other Details:
Languages:  eng     Pagination:  267-72     Citation Subset:  IM    
Affiliation:
Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adrenal Hyperplasia, Congenital / drug therapy*,  physiopathology*
Adult
Cohort Studies
Dexamethasone / therapeutic use*
Female
Fertility*
Glucocorticoids / therapeutic use*
Humans
Infant, Newborn
Pregnancy
Chemical
Reg. No./Substance:
0/Glucocorticoids; 50-02-2/Dexamethasone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Joint position statement of the Polish Cardiologic Society, the Polish Gynaecological Society and th...
Next Document:  Spontaneous premature ovarian failure: management challenges.