Genotyping of congenital adrenal hyperplasia due to 21-hydroxylase deficiency presenting as male infertility: case report and literature review

J Assist Reprod Genet. 2006 Sep-Oct;23(9-10):377-80. doi: 10.1007/s10815-006-9062-0. Epub 2006 Oct 11.

Abstract

We describe here two infertile male patients who were referred to our hospital with azoospermia at the ages of 33 and 30 years, respectively. Hormonal examinations led to a diagnosis of congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency in both patients. Genotyping revealed that the patients had a homozygous I172N and a heterozygous compound I172N/IVS2-13A/C>G mutation, respectively. Glucocorticoid replacement therapy succeeded in improving the seminal status of one patient, but not the other. For the latter patient and his wife, a pregnancy was achieved by testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI) following genetic counseling. It is important to investigate genotyping and to classify patients on the basis of genotypic information in order to arrive at better treatment strategies for male infertility; especially in counseling of TESE-ICSI.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Hyperplasia, Congenital / enzymology
  • Adrenal Hyperplasia, Congenital / genetics*
  • Adult
  • Dexamethasone / therapeutic use
  • Female
  • Genotype
  • Glucocorticoids / therapeutic use
  • Humans
  • Infertility, Male / genetics*
  • Male
  • Pregnancy
  • Pregnancy Outcome
  • Sperm Injections, Intracytoplasmic
  • Sperm Motility / drug effects
  • Steroid 21-Hydroxylase / genetics*

Substances

  • Glucocorticoids
  • Dexamethasone
  • Steroid 21-Hydroxylase