There are several treatment routes, including CAH-specific ones and general fertility therapies. Your doctor can help you decide on the right treatment for you.
Optimizing Steroid Treatment
“Optimizing [steroid] medications can help to bring back regular ovulation and periods, which can help with fertility,” says Dr. Ryan. For many women, that may mean increasing the dosage at certain times of your menstrual cycle and dialing back at others.
“In some cases, the actual steroid being prescribed may also need to change,” says Dr. Moravek.
Clomiphene Citrate (Clomid) or Letrozole to Stimulate Egg Release
“All fertility treatments that are offered to women without CAH are also options for women with CAH,” Moravek says.
Metformin for Insulin Resistance
IVF and Other Forms of Assisted Reproductive Technology
The American College of Obstetrics and Gynecology recommends that women with CAH who are trying to become pregnant, especially those undergoing IVF, should be offered the option of having genetic carrier screening. Genetic testing can determine whether your child may also be affected by CAH.
Future children are only at risk if the patient’s male partner or sperm donor also carries a gene mutation that can cause CAH, Moravek explains.
“In couples who both carry a CAH-causing mutation, embryos created by IVF can be screened to see if they will be affected by CAH with relatively high accuracy, or a diagnosis can be made by genetic testing of a pregnancy,” she says.
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