ECE2024 Eposter Presentations Adrenal and Cardiovascular Endocrinology (155 abstracts)
Gonadal impact of congenital adrenal hyperplasia in adulthood: a follow-up study
Hamdi Frikha 1 , Yassmine Abdelkafi 1 , Nesrine Dhieb 1 , Mouna Elleuch 1 , Mahdi Kamoun 1 , Thouraya Kamoun 2 , Mongia Hachicha 2 , Mouna Mnif 1 , Habib Sfar 3 , Mohamed Abid 1 & Nabila Rekik Majdoub 1
1Hedi Chaker University Hospital, Department of Endocrinology; 2Hedi Chaker University Hospital, Department of Pediatrics; 3Tahar Sfar University Hospital, Department of Endocrinology
Introduction: Advances in diagnosis and treatment over the years have improved the life expectancy and quality of life for individuals with congenital adrenal hyperplasia (CAH). The inevitable alteration of the hypercortisolism-hyperandrogenism balance with current CAH therapy could be responsible for several anomalies in the gonadotropic axis and compromise fertility. This study aims to investigate this aspect in an aging Tunisian population of patients with CAH.
Methods: A retrospective and descriptive study was conducted on patients with CAH followed at the endocrinology department of Hedi Chaker University Hospital in Sfax.
Results: Twenty-six patients (11 men and 15 women; mean age: 27.4 ± 8.2 years) were recruited. Evaluation of gonadal function in male subjects showed preserved Leydig function (Testosterone 5.23±2.34 ng/ml; LH 2.8±1.3 mUI/ml), Sertoli axis abnormalities in 50% of patients (Inhibin B 117.7±75.2 pg/ml), and spermatogenesis abnormalities (Azoospermia=2, oligoasthenospermia=1, oligo-astheno-teratospermia=1). Furthermore, adrenal rest tissue in the testicular tissue (TART) was observed in 6 patients with an ultrasound appearance of vascularized hypoechoic areas. In female subjects, hormonal exploration did not reveal ovarian dysfunction; however, a decrease in follicular reserves, evidenced by a low AMH level, was found in 33% of patients. Additionally, 6 out of 15 patients met at least two diagnostic criteria for polycystic ovary syndrome (PCOS). While infertility was present in only one patient, we observed 4 spontaneous pregnancies in 2 of our patients, resulting in the birth of 2 female newborns without genital anomalies.
Conclusion: The data from our series align with literature findings, although studies on aging CAH populations are infrequent. This underscores the importance of regular monitoring of gonadotropic function in both sexes, especially for the occurrence of TART in men and PCOS in women, which may compromise fertility.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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