title: Reversible infertility, pharmaceutical and spontaneous, in a male with late onset congenital adrenal hyperplasia, due to 21-hydroxylase deficiency.
abstract: The authors describe a case of a 35-year-old man with 5-year duration infertility. History, clinical examination, and laboratory tests have established the diagnosis of late-onset congenital adrenal hyperplasia, due to 21-hydroxylase deficiency. Treatment with dexamethasone resulted in improvement of sperm quality, and 4 months later a pregnancy was achieved. Two years after the patient fathered his first child, and while he had discontinued dexamethasone treatment, he succeeded at a second pregnancy. The authors conclude that (1) late-onset congenital adrenal hyperplasia presents with significant variation during the patient's lifetime; (2) glucocorticoid administration is necessary in infertile men with nonclassic form of 21-hydroxylase deficiency; and (3) in cases of male infertility of unknown origin, the patient must be scrutinized for congenital adrenal hyperplasia, especially the nonclassic form.
authors.affiliation: Second Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece.
authors.forename: I
authors.initials: I
authors.lastname: Kalachanis
authors.forename: D
authors.initials: D
authors.lastname: Rousso
authors.forename: A
authors.initials: A
authors.lastname: Kourtis
authors.forename: F
authors.initials: F
authors.lastname: Goutzioulis
authors.forename: G
authors.initials: G
authors.lastname: Makedos
authors.forename: D
authors.initials: D
authors.lastname: Panidis
mesh_terms: D000312:Adrenal Hyperplasia, Congenital / Q000201:enzymology / Q000503:physiopathology*; D000328:Adult; D003907:Dexamethasone / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000188:drug therapy* / Q000201:enzymology / Q000503:physiopathology; D008297:Male; D013255:Steroid 21-Hydroxylase / Q000378:metabolism*
chemical_list: D003907:Dexamethasone; D013255:Steroid 21-Hydroxylase