The DOI matches its Crossref record; 25 of the 25 references it cites were found in a registry or an index.
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.
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In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
Citations
Cites
Congenital Adrenal Hyperplasia
Speiser, P., & White, P. C. (1987) · New England Journal of Medicine · doi:10.1056/nejm198711263172211 · Cited by 1,420
Congenital adrenal hyperplasia
Speiser, P. W., & White, P. C. (2003) · New England Journal of Medicine · doi:10.1056/nejmra021561 · Cited by 1,405
Prenatal glucocorticoids and long-term programming
Seckl (2004) · European Journal of Endocrinology · doi:10.1530/eje.0.151u049 · Cited by 825
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
EHRMAN, D. A., Barnes, R. B., & Rosenfield, R. L. (1995) · Endocrine Reviews · doi:10.1210/edrv-16-3-322 · Cited by 498
Ehrmann, D. A. (1995) · Endocrine Reviews · doi:10.1210/er.16.3.322 · Cited by 394
Mulaikal, R. M., Migeon, C. J., & Rock, J. A. (1987) · New England Journal of Medicine · doi:10.1056/nejm198701223160402 · Cited by 358
Andersen, A. N., Devroey, P., & Arce, J. (2006) · Human Reproduction · doi:10.1093/humrep/del284 · Cited by 328
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
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
Self-citation
Research works printed but not linked: 1
- 10.1097/00006254-200304000-00024 · DOI
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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 1,468
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
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
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
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
Self-citation
Metadata
- 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
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › 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
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