Reassessing fecundity in women with classical congenital adrenal hyperplasia (CAH): normal pregnancy rate but reduced fertility rate
Abstract
Summary: Objective Fertility in women with classical congenital adrenal hyperplasia (CAH) has been reported low; however, the true pregnancy rate for women trying to conceive with this condition is unknown. Our aim was to calculate pregnancy rate for women with CAH calculated as a proportion of those who had attempted conception. Fertility expressed as live birth rate is also calculated. Patients One hundred and six women with classical CAH followed in a multidisciplinary service [81 salt‐losing (SL) and 25 nonsalt‐losing (NSL) form]. Results Twenty‐five (23·6%) women with CAH women considered motherhood, 23 had actively tried conception of whom 21 (91·3%) achieved 34 pregnancies. Pregnancy rate is no different from that in the normal population (95%). Pregnancy rates were similar in the SL (88·9%) and NSL (92·9%) subgroups but those with NSL‐CAH were more likely to seek motherhood than those with SL‐CAH (16/25 vs. 9/81). Optimized glucocorticoid and mineralocorticoid regimes during fertility monitoring resulted spontaneous conception in nearly all recent cases. Fertility rate was 0·25 live births per woman compared with 1·8 in the UK population ( P < 0·001). Conclusion We report a normal pregnancy rate (91·3%) for women with classical CAH, similar in SL and NSL subgroups. Fertility rate, however, remains much lower than in general population.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Suppression of follicular phase progesterone enhances the likelihood of ovulation and subsequent conception.
“suppression of follicular phase progesterone enhances the likelihood of ovulation and subsequent conception.110,111”
From Congenital adrenal hyperplasia (2017) · cites this paper as [110]
Several studies show that only a minority of women with classic CAH try to conceive.
“Several studies have shown that, for a variety of reasons, only a minority of women with classic CAH try to conceive (225, 257).”
From Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency: An Endocrine Society* Clinical Practice Guideline (2018) · cites this paper as [225]
Women with classic CAH who wish to conceive can achieve nearly normal pregnancy rates with adequate suppression of follicular-phase progesterone by optimizing glucocorticoid and mineralocorticoid treatments.
“Those who wish to conceive can achieve nearly normal pregnancy rates with adequate suppression of follicular-phase progesterone (,0.6 ng/ mL = 2 nmol/L, Table 5) (225) by optimizing GC and MC treatments.”
From Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency: An Endocrine Society* Clinical Practice Guideline (2018) · cites this paper as [225]
Caesarean section is the most common delivery method in CAH due to previous vaginal surgery and cephalopelvic disproportion; vaginal delivery has been reported in 16% to 42% of women, nearly all with a non-salt-wasting phenotype.
“Caesarean section is the most common method of delivery due to the high prevalence of previous vaginal surgery and cephalopelvic disproportion, although vaginal delivery has been reported in 16% to 42% of women, nearly all of whom had a non-salt-wasting phenotype (225, 257).”
From Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency: An Endocrine Society* Clinical Practice Guideline (2018) · cites this paper as [225]
Cites
Congenital Adrenal Hyperplasia
Speiser, P., & White, P. C. (1987) · New England Journal of Medicine · doi:10.1056/nejm198711263172211 · Cited by 1,409 · see citing works
Prenatal glucocorticoids and long-term programming
Seckl (2004) · European Journal of Endocrinology · doi:10.1530/eje.0.151u049 · Cited by 825 · see citing works
Definition and prevalence of subfertility and infertility
Gnoth, C., Godehardt, E., Frank-Herrmann, P., Friol, K., Tigges, J., & Freundl, G. (2005) · Human Reproduction · doi:10.1093/humrep/deh870 · Cited by 603 · see citing works
EHRMAN, D. A., Barnes, R. B., & Rosenfield, R. L. (1995) · Endocrine Reviews · doi:10.1210/edrv-16-3-322 · Cited by 502 · see citing works
Ehrmann, D. A. (1995) · Endocrine Reviews · doi:10.1210/er.16.3.322 · Cited by 394 · see citing works
Mulaikal, R. M., Migeon, C. J., & Rock, J. A. (1987) · New England Journal of Medicine · doi:10.1056/nejm198701223160402 · Cited by 358 · see citing works
Andersen, A. N., Devroey, P., & Arce, J. (2006) · Human Reproduction · doi:10.1093/humrep/del284 · Cited by 328 · see citing works
Meyer-Bahlburg, H. F. L., Dolezal, C., Baker, S. W., & New, M. I. (2008) · Archives of Sexual Behavior · doi:10.1007/s10508-007-9265-1 · Cited by 326 · see citing works
Crouch, N. S., Liao, L. M., Woodhouse, C. R. J., Conway, G. S., & Creighton, S. M. (2008) · Journal of Urology · doi:10.1016/j.juro.2007.09.079 · Cited by 249 · see citing works
Self-citationGastaud, F., Bouvattier, C. M., Duranteau, L., Brauner, R., Thibaud, E., Kutten, F., & Bougneres, P. F. (2007) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-1757 · Cited by 187 · see citing works
Congenital adrenal hyperplasia in adults: a review of medical, surgical and psychological issues
Ogilvie, M., Crouch, N. S., Rumsby, G., Creighton, S. M., Liao, L., & Way, G. S. C. (2005) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2005.02410.x · Cited by 136 · see citing works
Self-citationHoimes‐Walker, D. J., Conway, G. S., Honour, J. W., Rumsby, G., & Jacobs, H. S. (1995) · Clinical Endocrinology · doi:10.1111/j.1365-2265.1995.tb02034.x · Cited by 134 · see citing works
Self-citationGENDER AND SEXUALITY IN CLASSIC CONGENITAL ADRENAL HYPERPLASIA
Meyer‐Bahlburg, H. F. L. (2001) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/s0889-8529(08)70024-0 · Cited by 121 · see citing works
Endocrinology and Metabolism Clinics of North America
(2020) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/s0889-8529(20)30021-9 · Cited by 116 · see citing works
Helleday, J. (1993) · Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.76.4.933 · Cited by 111 · see citing works
Pregnancy outcomes in women with congenital virilizing adrenal hyperplasia
Lo, J. C., & Grumbach, M. M. (2001) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/s0889-8529(08)70027-6 · Cited by 98 · see citing works
Fertility in Women With Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency
Stikkelbroeck, N. M. M. L., Hermus, A. R., Braat, D. D. M., & Otten, B. J. (2003) · Obstetrical & Gynecological Survey · doi:10.1097/01.ogx.0000062966.93819.5b · Cited by 95 · see citing works
The role of bilateral adrenalectomy in the treatment of congenital adrenal hyperplasia
Van Wyk, J. J., & Ritzen, E. M. (2003) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2002-022026 · Cited by 89 · see citing works
Jääskeläinen, J., Hippeläinen, M., Kiekara, O., & Voutilainen, R. (2000) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1034/j.1600-0412.2000.079008687.x · Cited by 70 · see citing works
Hoepffner, W., Schulze, E., Bennek, J., Keller, E., & Willgerodt, H. (2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2003.10.024 · Cited by 67 · see citing works
Outcome of bilateral adrenalectomy in congenital adrenal hyperplasia: one unit’s experience
Ogilvie, C. M., Rumsby, G., Kurzawinski, T., & Conway, G. S. (2006) · European Journal of Endocrinology · doi:10.1530/eje.1.02096 · Cited by 55 · see citing works
Self-citationFemale pseudohermaphroditism caused by maternal congenital adrenal hyperplasia
Kai, H., Nose, O., Iida, Y., Ono, J., Harada, T., & Yabuuchi, H. (1979) · The Journal of Pediatrics · doi:10.1016/s0022-3476(79)80522-3 · Cited by 33 · see citing works
Dumić, M., Janjanin, N., Ille, J., Žunec, R., Špehar, A., Zlopaša, G., Francetić, I., & New, M. I. (2005) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem.2005.18.9.887 · Cited by 30 · see citing works
Fertility and its Complications in a Patient with Salt Losing Congenital Adrenal Hyperplasia
Zacharin, M. (1999) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem.1999.12.1.89 · Cited by 27 · see citing works
Flagged first, then by citations
1 of the 25 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Speiser, P. W., Azziz, R., Baskin, L. S., Ghizzoni, L., Hensle, T. W., Merke, D. P., Meyer-Bahlburg, H. F. L., Miller, W. L., Montori, V. M., Oberfield, S. E., et al. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-2631 · Cited by 1,484 · see citing works
Speiser, P. W., Arlt, W., Auchus, R. J., Baskin, L. S., Conway, G. S., Merke, D. P., Meyer-Bahlburg, H. F. L., Miller, W. L., Murad, M. H., Oberfield, S. E., et al. (2018) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2018-01865 · Cited by 1,234 · see citing works
Self-citationCongenital adrenal hyperplasia
El-Maouche, D., Arlt, W., & Merke, D. P. (2017) · The Lancet · doi:10.1016/s0140-6736(17)31431-9 · Cited by 669 · see citing works
Congenital Adrenal Hyperplasia—Current Insights in Pathophysiology, Diagnostics, and Management
Claahsen - van der Grinten, H. L., Speiser, P. W., Ahmed, S. F., Arlt, W., Auchus, R. J., Falhammar, H., Flück, C. E., Guasti, L., Huebner, A., Kortmann, B. B. M., et al. (2022) · Endocrine Reviews · doi:10.1210/endrev/bnab016 · Cited by 556 · see citing works
Health status of adults with congenital adrenal hyperplasia: a cohort study of 203 patients
Arlt, W., Willis, D. S., Wild, S. H., Krone, N., Doherty, E. J., Hahner, S., Han, T. S., Carroll, P. V., Conway, G. S., Rees, D. A., et al. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-0917 · Cited by 506 · see citing works
Self-citationCongenital adrenal hyperplasia due to 21-hydroxylase deficiency
Merke, D. P., & Auchus, R. J. (2020) · New England Journal of Medicine · doi:10.1056/nejmra1909786 · Cited by 341 · see citing works
Speiser, P., Arlt, W., Rj, A., Baskin, L., Conway, G. S., Merke, D. P., Meyer‐Bahlburg, H. F. L., Miller, W. L., Murad, M. H., Oberfield, S., et al. (2019) · Yearbook of pediatric endocrinology · doi:10.1530/ey.16.8.5 · Cited by 301 · see citing works
Self-citationCongenital adrenal hyperplasia
Auer, M. K., Nordenström, A., Lajić, S., & Reisch, N. (2022) · The Lancet · doi:10.1016/s0140-6736(22)01330-7 · Cited by 232 · see citing works
Fertility in women with nonclassical congenital adrenal hyperplasia due to 21-hydroxylase deficiency
Bidet, M., Bellanné-Chantelot, C., Galand-Portier, M.-B., Golmard, J.-L., Tardy, V., Morel, Y., Clauin, S., Coussieu, C., Boudou, P., Mowzowicz, I., et al. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-1383 · Cited by 204 · see citing works
Congenital Adrenal Hyperplasia
Witchel, S. F. (2017) · Journal of Pediatric and Adolescent Gynecology · doi:10.1016/j.jpag.2017.04.001 · Cited by 187 · see citing works
Adrenal Steroidogenesis and Congenital Adrenal Hyperplasia
Turcu, A. F., & Auchus, R. J. (2015) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2015.02.002 · Cited by 177 · see citing works
Contraception across the transmasculine spectrum
Krempasky, C., Harris, M., Abern, L., & Grimstad, F. W. (2019) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2019.07.043 · Cited by 168 · see citing works
Nordenström, A., & Falhammar, H. (2019) · European Journal of Endocrinology · doi:10.1530/eje-18-0712 · Cited by 158 · see citing works
Congenital adrenal hyperplasia.
Witchel, S., & Azziz, R. (2011) · Journal of Pediatric and Adolescent Gynecology · doi:10.1016/j.jpag.2010.10.001 · Cited by 50 · see citing works
Clinical perspectives in congenital adrenal hyperplasia due to 11β-hydroxylase deficiency
Bulsari, K., & Falhammar, H. (2016) · Endocrine · doi:10.1007/s12020-016-1189-x · Cited by 139 · see citing works
Krone, N., Rose, I. T., Willis, D. S., Hodson, J., Wild, S. H., Doherty, E. J., Hahner, S., Parajes, S., Stimson, R. H., Han, T. S., et al. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-3343 · Cited by 119 · see citing works
Pasterski, V., Zucker, K. J., Hindmarsh, P. C., Hughes, I. A., Acerini, C., Spencer, D., Neufeld, S., & Hines, M. (2015) · Archives of Sexual Behavior · doi:10.1007/s10508-014-0385-0 · Cited by 127 · see citing works
Falhammar, H., & Nordenström, A. (2015) · Endocrine · doi:10.1007/s12020-015-0656-0 · Cited by 127 · see citing works
Approach to the patient: the adult with congenital adrenal hyperplasia
Auchus, R. J., & Arlt, W. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-1440 · Cited by 121 · see citing works
Bouvattier, C., Esterle, L., Renoult-Pierre, P., de la Perrière, A. B., Illouz, F., Kerlan, V., Pascal-Vigneron, V., Drui, D., Christin-Maitre, S., Galland, F., et al. (2015) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2014-4124 · Cited by 116 · see citing works
Strandqvist, A., Falhammar, H., Lichtenstein, P., Hirschberg, A. L., Wedell, A., Norrby, C., Nordenskjöld, A., Frisén, L., & Nordenström, A. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-3326 · Cited by 111 · see citing works
Health Problems in Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency
Reisch, N., Arlt, W., & Krone, N. P. (2011) · Hormone Research in Paediatrics · doi:10.1159/000327794 · Cited by 107 · see citing works
Clinical outcomes in the management of congenital adrenal hyperplasia
Falhammar, H., & Thorén, M. (2012) · Endocrine · doi:10.1007/s12020-011-9591-x · Cited by 106 · see citing works
Fertility in patients with congenital adrenal hyperplasia
Reichman, D. E., White, P. C., New, M. I., & Rosenwaks, Z. (2013) · Fertility and Sterility · doi:10.1016/j.fertnstert.2013.11.002 · Cited by 104 · see citing works
Treatment and health outcomes in adults with congenital adrenal hyperplasia
Han, T. S., Walker, B. R., Arlt, W., & Ross, R. J. (2014) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2013.239 · Cited by 102 · see citing works
NonClassic Congenital Adrenal Hyperplasia
Witchel, S. F., & Azziz, R. (2010) · International Journal of Pediatric Endocrinology · doi:10.1155/2010/625105 · Cited by 132 · see citing works
Abiraterone acetate to lower androgens in women with classic 21-hydroxylase deficiency
Auchus, R. J., Buschur, E. O., Chang, A. Y., Hammer, G. D., Ramm, C., Madrigal, D., Wang, G., Gonzalez, M., Xu, X. S., Smit, J. W., et al. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2014-1258 · Cited by 97 · see citing works
Modified-Release Hydrocortisone in Congenital Adrenal Hyperplasia
Merke, D. P., Mallappa, A., Arlt, W., Brac de la Perriere, A., Lindén Hirschberg, A., Juul, A., Newell-Price, J., Perry, C. G., Prete, A., Rees, D. A., et al. (2021) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgab051 · Cited by 109 · see citing works
NonClassic Congenital Adrenal Hyperplasia
Witchel, S., & Azziz, R. (2010) · International Journal of Pediatric Endocrinology · doi:10.1186/1687-9856-2010-625105 · Cited by 85 · see citing works
Adrenal diseases during pregnancy: pathophysiology, diagnosis and management strategies
Kamoun, M., Mnif, M. F., Charfi, N., Kacem, F. H., Naceur, B. B., Mnif, F., Dammak, M., Rekik, N., & Abid, M. (2014) · The American Journal of the Medical Sciences · doi:10.1097/maj.0b013e31828aaeee · Cited by 77 · see citing works
MANAGEMENT OF ENDOCRINE DISEASE: Gonadal dysfunction in congenital adrenal hyperplasia
Claahsen-van der Grinten, H. L., Stikkelbroeck, N., Falhammar, H., & Reisch, N. (2021) · European Journal of Endocrinology · doi:10.1530/eje-20-1093 · Cited by 72 · see citing works
Fertility in disorders of sex development: A review
Batavia, J. V., & Kolon, T. F. (2016) · Journal of Pediatric Urology · doi:10.1016/j.jpurol.2016.09.015 · Cited by 71 · see citing works
Auchus, R. J., Witchel, S. F., Leight, K. R., Aisenberg, J. E., Azziz, R., Bachega, T. A. S. S., Baker, L. A., Baratz, A. B., Baskin, L. S., Berenbaum, S. A., et al. (2010) · International Journal of Pediatric Endocrinology · doi:10.1155/2010/275213 · Cited by 69 · see citing works
Self-citationManagement considerations for the adult with congenital adrenal hyperplasia
Auchus, R. J. (2015) · Molecular and Cellular Endocrinology · doi:10.1016/j.mce.2015.01.039 · Cited by 65 · see citing works
Hirschberg, A. L., Gidlöf, S., Falhammar, H., Frisén, L., Almqvist, C., Nordenskjöld, A., & Nordenström, A. (2021) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaa801 · Cited by 65 · see citing works
Disorders of sex development: Summaries of long-term outcome studies
Schober, J. M., Nordenström, A., Hoebeke, P. B., Lee, P. A., Houk, C. P., Looijenga, L. H. J., Manzoni, G., Reiner, W. G., & Woodhouse, C. R. J. (2012) · Journal of Pediatric Urology · doi:10.1016/j.jpurol.2012.08.005 · Cited by 64 · see citing works
46,XX DSD: the masculinised female
Auchus, R. J., & Chang, A. Y. (2010) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2009.11.001 · Cited by 63 · see citing works
Management of CAH during pregnancy
Witchel, S. F. (2012) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/med.0b013e32835a1a2e · Cited by 62 · see citing works
Disorders of Sex Development of Adrenal Origin
Finkielstain, G. P., Vieites, A., Bergadá, I., & Rey, R. A. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.770782 · Cited by 60 · see citing works
Classic congenital adrenal hyperplasia and its impact on reproduction
Gomes, L. G., Bachega, T. A. S. S., & Mendonca, B. B. (2019) · Fertility and Sterility · doi:10.1016/j.fertnstert.2018.11.037 · Cited by 58 · see citing works
Bachelot, A., Grouthier, V., Courtillot, C., Dulon, J., & Touraine, P. A. (2017) · European Journal of Endocrinology · doi:10.1530/eje-16-0888 · Cited by 55 · see citing works
Adrenal disorders in pregnancy
Monticone, S., Auchus, R. J., & Rainey, W. E. (2012) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2012.155 · Cited by 53 · see citing works
Bachelot, A., Chakhtoura, Z., Plu‐Bureau, G., Coudert, M., Coussieu, C., Badachi, Y., Dulon, J., Charbit, B., & Touraine, P. A. (2012) · European Journal of Endocrinology · doi:10.1530/eje-12-0454 · Cited by 53 · see citing works
Non-classic congenital adrenal hyperplasia
Witchel, S. F. (2013) · Steroids · doi:10.1016/j.steroids.2013.04.010 · Cited by 52 · see citing works
Pregnancy in women with nonclassic congenital adrenal hyperplasia: time to conceive and outcome
Eyal, O., Ayalon‐Dangur, I., Segev‐Becker, A., Schachter‐Davidov, A., Israel, S., & Weintrob, N. (2017) · Clinical Endocrinology · doi:10.1111/cen.13429 · Cited by 47 · see citing works
Long-Term Outcome of Patients With Congenital Adrenal Hyperplasia Due to 21-hydroxylase Deficiency
Mnif, M. F., Kamoun, M., Mnif, F., Charfi, N., Kallel, N., Naceur, B. B., Rekik, N. M., Abid, M., Mnif, Z., Sfar, M. H., et al. (2012) · The American Journal of the Medical Sciences · doi:10.1097/maj.0b013e31824369e4 · Cited by 49 · see citing works
Congenital Adrenal Hyperplasia: Classification of Studies Employing Psychological Endpoints
Stout, S. A., Литвак, М. М., Robbins, N. M., & Sandberg, D. E. (2010) · International Journal of Pediatric Endocrinology · doi:10.1155/2010/191520 · Cited by 53 · see citing works
Clinical advances in the pharmacotherapy of congenital adrenal hyperplasia
Prete, A., Auchus, R. J., & Ross, R. J. (2022) · White Rose Research Online (University of Leeds, The University of Sheffield, University of York) · Cited by 46 · see citing works
Nordenström, A. (2011) · Current Opinion in Pediatrics · doi:10.1097/mop.0b013e32834810a4 · Cited by 42 · see citing works
Nonclassic congenital adrenal hyperplasia
Witchel, S. F. (2012) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/med.0b013e3283534db2 · Cited by 42 · see citing works
Long-Term Outcomes of Congenital Adrenal Hyperplasia
Nordenström, A., Lajić, S., & Falhammar, H. (2022) · Endocrinology and Metabolism · doi:10.3803/enm.2022.1528 · Cited by 41 · see citing works
Infertility and Reproductive Function in Patients with Congenital Adrenal Hyperplasia
Lekarev, O., Lin-Su, K., & Vogiatzi, M. G. (2015) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2015.07.009 · Cited by 38 · see citing works
Bachelot, A., Golmard, J. L., Dulon, J., Dahmoune, N., Leban, M., Bouvattier, C., Cabrol, S., Leger, J., Polak, M., & Touraine, P. (2015) · European Journal of Endocrinology · doi:10.1530/eje-14-0978 · Cited by 46 · see citing works
The management of congenital adrenal hyperplasia during preconception, pregnancy, and postpartum
Maher, J. Y., Gomez‐Lobo, V., & Merke, D. P. (2022) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-022-09770-5 · Cited by 40 · see citing works
Reisch, N. (2019) · Experimental and Clinical Endocrinology & Diabetes · doi:10.1055/a-0820-2085 · Cited by 38 · see citing works
Pregnancy in Congenital Adrenal Hyperplasia
Reisch, N. (2019) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2019.05.011 · Cited by 37 · see citing works
Assisted Reproduction in Congenital Adrenal Hyperplasia
Chatziaggelou, A., Sakkas, E. G., Votino, R., Papagianni, M., & Mastorakos, G. P. (2019) · Frontiers in Endocrinology · doi:10.3389/fendo.2019.00723 · Cited by 35 · see citing works
Turcu, A. F., El-Maouche, D., Zhao, L., Nanba, A. T., Gaynor, A., Veeraraghavan, P., Auchus, R. J., & Merke, D. P. (2020) · European Journal of Endocrinology · doi:10.1530/eje-20-0129 · Cited by 33 · see citing works
Fertility and sexuality issues in congenital lifelong urology patients: female aspects
Win, G. D., Dautricourt, S., Deans, R., Hamid, R., Hanna, M. K., Khavari, R., Misseri, R., Mueller, M. G., Roth, J. D., & Spinoit, A. (2020) · World Journal of Urology · doi:10.1007/s00345-020-03461-z · Cited by 33 · see citing works
Mooij, C. F., Webb, E. A., der Grinten, H. L. C., & Krone, N. P. (2016) · Archives of Disease in Childhood · doi:10.1136/archdischild-2016-311910 · Cited by 31 · see citing works
Williamson, C., & Scott, R. (2021) · doi:10.1093/med/9780198851899.003.0005 · Cited by 31 · see citing works
Sarafoglou, K., Merke, D. P., Reisch, N., der Grinten, H. L. C., Falhammar, H., & Auchus, R. J. (2023) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgad134 · Cited by 31 · see citing works
Congenital adrenal hyperplasia in adults
Auchus, R. J. (2010) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/med.0b013e32833961d7 · Cited by 30 · see citing works
Growth and Reproductive Outcomes in Congenital Adrenal Hyperplasia
Nebesio, T. D., & Eugster, E. A. (2010) · International Journal of Pediatric Endocrinology · doi:10.1155/2010/298937 · Cited by 33 · see citing works
Disorders of Sexual Development in Adult Women
Gomez‐Lobo, V., Oelschlager, A. A., & for the North American Society for Pediatric and Adolescent Gynecology (2016) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000001672 · Cited by 27 · see citing works
Kocova, M., Anastasovska, V., & Falhammar, H. (2020) · Endocrine · doi:10.1007/s12020-020-02323-3 · Cited by 24 · see citing works
Prenatal treatment of congenital adrenal hyperplasia-not standard of care
Witchel, S. F., & Miller, W. L. (2012) · Journal of Genetic Counseling · doi:10.1007/s10897-012-9508-8 · Cited by 29 · see citing works
Should CAH in Females Be Classified as DSD?
González, R., & Ludwikowski, B. M. (2016) · Frontiers in Pediatrics · doi:10.3389/fped.2016.00048 · Cited by 24 · see citing works
Long‐term health consequences of congenital adrenal hyperplasia
Pofi, R., Ji, X., Krone, N. P., & Tomlinson, J. (2023) · Clinical Endocrinology · doi:10.1111/cen.14967 · Cited by 24 · see citing works
Substitution therapy in adult patients with congenital adrenal hyperplasia
Reisch, N. (2014) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2014.11.002 · Cited by 23 · see citing works
Mnif, M. F., Kamoun, M., Kacem, F. H., Mnif, F., Charfi, N., Naceur, B. B., Rekik, N., & Abid, M. (2013) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/2230-8210.117196 · Cited by 22 · see citing works
Contraception across transgender
Mancini, I., Alvisi, S., Gava, G., Seracchioli, R., & Meriggiola, M. C. (2021) · International Journal of Impotence Research · doi:10.1038/s41443-021-00412-z · Cited by 22 · see citing works
Endocrine factors associated with infertility in women: an updated review
Concepción‐Zavaleta, M. J., Arroyo, J., Aldave, J. E. Q., Durand‐Vásquez, M. D. C., Ildefonso-Najarro, S. P., Rafael-Robles, L. D. P., Urteaga, L. A. C., Osorio, E. R. G., Suárez-Rojas, J., & Paz‐Ibarra, J. (2023) · Expert Review of Endocrinology & Metabolism · doi:10.1080/17446651.2023.2256405 · Cited by 23 · see citing works
Long-term health issues related to disorders or differences in sex development/intersex
Beale, J. M. A., & Creighton, S. M. (2016) · Maturitas · doi:10.1016/j.maturitas.2016.10.003 · Cited by 22 · see citing works
Growth and Reproductive Outcomes in Congenital Adrenal Hyperplasia
Nebesio, T. D., & Eugster, E. (2010) · International Journal of Pediatric Endocrinology · doi:10.1186/1687-9856-2010-298937 · Cited by 22 · see citing works
Russian clinical practice guidelines «congenital adrenal hyperplasia»
Mokrysheva, N. G., Mel'nichenko, G. A., Adamyan, L. V., Troshina, E. A., Молашенко, Н. В., Игоревна, С. А., Uvarova, E. V., Esayan, E. R. M., Andreeva, E. N., Ужегова, Ж. А., et al. (2021) · Obesity and metabolism · doi:10.14341/omet12787 · Cited by 27 · see citing works
Dwiggins, M. L., Brookner, B., Fowler, K. G., Veeraraghavan, P., Gomez‐Lobo, V., & Merke, D. P. (2020) · Journal of the Endocrine Society · doi:10.1210/jendso/bvaa131 · Cited by 22 · see citing works
Guo, X., Zhang, Y., Yu, Y., Zhang, L., Ullah, K., Ji, M., Jin, B., & Shu, J. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.982953 · Cited by 20 · see citing works
Challenges Waiting for an Adult with DSD
Nowotny, H. F., & Reisch, N. (2022) · Hormone Research in Paediatrics · doi:10.1159/000527433 · Cited by 22 · see citing works
Congenital Adrenal Hyperplasia
Speiser, P. (2015) · F1000Research · doi:10.12688/f1000research.6543.1 · Cited by 18 · see citing works
Management of the Adult with Congenital Adrenal Hyperplasia
Auchus, R. J. (2010) · International Journal of Pediatric Endocrinology · doi:10.1155/2010/614107 · Cited by 19 · see citing works
Choi, J., & Yoo, H. (2017) · Korean Journal of Pediatrics · doi:10.3345/kjp.2017.60.2.31 · Cited by 17 · see citing works
Identity, sexuality, and parenthood in women with congenital adrenal hyperplasia
Engberg, H., Möller, A., Hagenfeldt, K., Nordenskjöld, A., & Frisén, L. (2020) · Journal of Pediatric and Adolescent Gynecology · doi:10.1016/j.jpag.2020.05.005 · Cited by 15 · see citing works
Engberg, H., Nordenström, A., & Hirschberg, A. L. (2024) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgae696 · Cited by 13 · see citing works
Concolino, P., & Falhammar, H. (2025) · Journal of the Endocrine Society · doi:10.1210/jendso/bvaf018 · Cited by 12 · see citing works
Controverses et challenges sur le développement sexuel différent (DSD)
Bessiène, L., Lombès, M., & Bouvattier, C. M. (2018) · Annales d Endocrinologie · doi:10.1016/s0003-4266(18)31235-6 · Cited by 12 · see citing works
Auer, M. K., Minea, C. E., Quinkler, M. O., Bancos, I., Beuschlein, F., Meyer, G., Lottspeich, C., Bidlingmaier, M., Rieger, E., Nowotny, H. F., et al. (2024) · Journal of the Endocrine Society · doi:10.1210/jendso/bvae211 · Cited by 11 · see citing works
Dörr, H. G., Heß, J., Penger, T., Marx, M., & Oppelt, P. G. (2018) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-018-2091-8 · Cited by 11 · see citing works
Congenital adrenal hyperplasia in pregnancy: approach depends on who is the ‘patient’
Keely, E., & Malcolm, J. (2012) · Obstetric Medicine · doi:10.1258/om.2012.120015 · Cited by 10 · see citing works
Prenatal and Pregnancy Management of Congenital Adrenal Hyperplasia
Nowotny, H. F., Tschaidse, L., Auer, M. K., & Reisch, N. (2024) · Clinical Endocrinology · doi:10.1111/cen.15131 · Cited by 10 · see citing works
Bancos, I., Kim, H., Cheng, H. K.-H., Rodrı́guez-Lee, M., Coope, H., Cicero, S., Goldsmith, H., Lin, V. H., & Jeha, G. S. (2025) · Expert Review of Endocrinology & Metabolism · doi:10.1080/17446651.2025.2450423 · Cited by 7 · see citing works
The impact of genetic steroid disorders on human fertility
Reichman, D., & Rosenwaks, Z. (2016) · The Journal of Steroid Biochemistry and Molecular Biology · doi:10.1016/j.jsbmb.2016.04.014 · Cited by 7 · see citing works
The impact of CYP21A2 (P30L/I172N) genotype on female fertility in one family
Kočova, M., Anastasovska, V., & Bitovska, I. (2019) · European journal of medical research · doi:10.1186/s40001-019-0379-4 · Cited by 7 · see citing works
Health problems of adolescent and adult patients with 21-hydroxylase deficiency
Tajima, T. (2018) · Clinical Pediatric Endocrinology · doi:10.1297/cpe.27.203 · Cited by 7 · see citing works
Fertility Issues in Pediatric Urology
Kieran, K., & Shnorhavorian, M. (2018) · Urologic Clinics of North America · doi:10.1016/j.ucl.2018.06.006 · Cited by 7 · see citing works
Congenital adrenal hyperplasia
Krone, N. P., & Hughes, I. A. (2020) · doi:10.1093/med/9780198746690.003.0250 · Cited by 7 · see citing works
Congenital adrenal hyperplasia and pregnancy
Shorakae, S., & Teede, H. J. (2013) · BMJ Case Reports · doi:10.1136/bcr-2013-010299 · Cited by 7 · see citing works
Lao, Q., Schulman, A., Kulkarni, S., Kollender, S., Bick, D., Moon, A., Burkardt, D. D., & Merke, D. P. (2025) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaf546 · Cited by 6 · see citing works
Sandberg, D. E., Gardner, M., & Lapham, Z. K. (2025) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgae668 · Cited by 6 · see citing works
Fertility and pregnancy in adrenal insufficiency
Green, D., Dineen, R., O’Reilly, M., & Sherlock, M. (2023) · Endocrine Connections · doi:10.1530/ec-23-0088 · Cited by 8 · see citing works
- Authors
- Casteràs, A., De Silva, P., Rumsby, G., & Conway, G. S.
- Affiliations
- University College Hospital (GB)
- Corresponding author
- Conway, Gerard S.
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2009-05-13
- Volume
- 70
- Issue
- 6
- Pages
- 833-837
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2028550929
- Cited by
- 190
- References
- 25
- Citations by year
- 2026: 8 · 2025: 12 · 2024: 7 · 2023: 13 · 2022: 17 · 2021: 14 · 2020: 12 · 2019: 9 · 2018: 9 · 2017: 8 · 2016: 11 · 2015: 10 · 2014: 8 · 2013: 18 · 2012: 11
- FWCI
- 4.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research
- University College London Hospitals NHS Foundation Trust
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Keywords
- classical congenital adrenal hyperplasia, female fertility, pregnancy rate, live birth rate, glucocorticoid therapy, mineralocorticoid therapy, fertility monitoring, spontaneous conception
- MeSH terms
- Adolescent, Adrenal Hyperplasia, Congenital, Adult, Birth Rate, Female, Fertility, Follow-Up Studies, Humans, Middle Aged, Pregnancy, Cohort Studies, Pregnancy Rate, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
