Fertilité et grossesse chez les patientes présentant une hyperplasie congénitale des surrénales par déficit en 21-hydroxylase.

21-Hydroxylase deficiency (21OHD) is the most common cause of congenital adrenal hyperplasia. Increased production of adrenal-derived androgens and progesterone in 21OHD women interfere with their reproductive function and their fertility in many different ways, depending of the severity of the disease. Sexuality and fertility in women with classic 21OHD is impaired, due to several issues such as disrupted gonadotropic axis due to androgen and progesterone overproduction, and mechanical, psychological factors related to genital surgery. Fertility and fecundity in these women get better over the years. In women with non classic 21OHD form, subfertility is relative when they receive hydrocortisone preconceptionally and during the first trimester of pregnancy to avoid increased miscarriage risk. In all cases, genetic counselling is primordial prior to any pregnancy. [ABSTRACT FROM AUTHOR]