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Updated: Mar 30, 2026

Fertility Preservation in Patients with Severe Ovarian Dysfunction
Published on: March 25, 2021
Infertility and Reproductive Function in Patients with Congenital Adrenal Hyperplasia: Pathophysiology, Advances in
Oksana Lekarev1, Karen Lin-Su1, Maria G Vogiatzi2
1Pediatric Endocrinology, Weill Cornell Medical College, New York, NY, USA.
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.
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