A case report: reversible male infertility due to congenital adrenal hyperplasia

We have studied a 32-year-old patient who was infertile because of azoospermia, We made the final diagnosis of non-classical congenital adrenal hyperplasia (CAH) caused by 21-hydroxylase deficiency with adrenal rest tumor of bilateral testes and bilateral adrenal myelolipoma. The patient was given 1...

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Bibliographic Details
Published inNippon Hinyokika Gakkai zasshi Vol. 84; no. 11; p. 2031
Main Authors Iwamoto, T, Yajima, M, Tanaka, H, Minagawa, N, Osada, T
Format Journal Article
LanguageJapanese
Published Japan 01.11.1993
Subjects
Adrenal Hyperplasia, Congenital - complications
Adult
Dexamethasone - administration & dosage
Humans
Infertility, Male - drug therapy
Infertility, Male - etiology
Male
Oligospermia - drug therapy
Sperm Count
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Summary:We have studied a 32-year-old patient who was infertile because of azoospermia, We made the final diagnosis of non-classical congenital adrenal hyperplasia (CAH) caused by 21-hydroxylase deficiency with adrenal rest tumor of bilateral testes and bilateral adrenal myelolipoma. The patient was given 1.5 mg/day dexamethasone. Decreases in the levels of 17 OHP and adrenal androgen were rapidly observed. After 5 months of treatment, semen analysis showed a sperm density of 2 x 10(4)/ml with 50% motile spermatozoa. His wife became pregnant and delivered of a healthy daughter. We conclude that chronic suppression of gonadotropins secretion caused by overproduction of adrenal androgens in CAH would appear to be the cause for the failure of testicular development and spermatogenesis.
ISSN:0021-5287
DOI:10.5980/jpnjurol1989.84.2031