Concepts to Practice: The Evolving Landscape of Congenital Adrenal Hyperplasia Management Strategies-Presentation: Evolving Landscape of Congenital Adrenal Hyperplasia Management Strategies

Video Transcription

Video Summary

The video content discusses the management of congenital adrenal hyperplasia (CAH) in adults and its implications for fertility. Two patient cases are presented to illustrate different treatment approaches. The first case involves a pregnant woman with non-classical CAH who successfully conceives after trying clomiphene and receives low-dose glucocorticoid therapy during pregnancy. The second case focuses on a male with classical CAH who wants to start a family. The recommended approach for this case is glucocorticoid therapy with an anti-androgen to suppress adrenal androgen production. The patient in this case is able to conceive after a few months of therapy. In summary, the guidelines suggest that fertility in adults with CAH can be managed with options such as clomiphene, gonadotropin therapy, or in vitro fertilization. Glucocorticoid therapy may be used to suppress adrenal androgen production and protect fertility, although it is not always necessary. Monitoring adrenal function during pregnancy and adjusting glucocorticoid doses as needed is crucial. In adults with classical CAH who want to start a family, the recommended approach is glucocorticoid therapy with or without an anti-androgen. Treatment aims to normalize androgen levels and improve spermatogenesis. Regular monitoring and adjustment of treatment are important in managing both non-classical and classical CAH. The video also emphasizes the need for individualized treatment plans based on patient symptoms, goals, and hormone levels. It mentions various glucocorticoids and other medications that can be used and highlights the importance of monitoring for complications such as adrenal rest tumors. Overall, the video stresses the need for personalized treatment approaches to achieve optimal outcomes while managing potential risks.

Keywords

congenital adrenal hyperplasia

CAH

management

fertility

glucocorticoid therapy

pregnancy

anti-androgen

adrenal androgen production

gonadotropin therapy

in vitro fertilization

adrenal function monitoring

classical CAH


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