Why do patients with congenital adrenal hyperplasia (CAH) have a decreased fertility rate?

Updated: Oct 06, 2020
  • Author: Thomas A Wilson, MD; Chief Editor: Sasigarn A Bowden, MD  more...
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Female patients with virilizing forms of adrenal hyperplasia have a decreased fertility rate. [27] The reasons are believed to be multifactorial and include abnormal genital anatomy, vaginal stenosis, and poor control of adrenal androgen production that results in diminished ovulation. When pregnancy does occur, the baby is generally born by means of caesarian delivery because of vaginal stenosis or an android pelvis. Virilization of female infants born to mothers with congenital adrenal hyperplasia has not been reported but is potentially possible if the condition is uncontrolled.

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