Skip to Main content Skip to Navigation
Master Thesis

Étude de la fertilité et des grossesses dans une cohorte de femmes présentant une hyperplasie congénitale des surrénales par déficit en 21-hydroxylase de forme non classique

Abstract : Introduction: fertility in patients with nonclassical congenital adrenal hyperplasia (NCAH) has been poorly studied. Hydrocortisone (HC) may decrease the time to conceive and the rate of miscarriage in these patients. The main objective of our study was to support the data on the subject. The secondary objective was to identify factors that could impact reproductive parameters, with a particular interest in HC and genetic status. Patients and methods: a retrospective study was conducted, involving 175 patients with NCAH confirmed by genetics, having consulted in our center between 2010 and 2019. Results: among the 96 patients with parental project, 87 presented 179 desired pregnancies, 56% under treatment and 44% without, and 77 obtained 129 live births. Two-thirds of the patients regularized their cycle, and the levels of androgens and progesterone decreased significantly, following the introduction of HC. This treatment was associated with a shortening of the time to conceive (coef β = -0.196, IC = [-10.7; -0.91], p = 0.021). The androgen levels and the time to conceive were associated with the outcome of pregnancy, with a decrease in the rate of miscarriage in parallel with their decrease (OR = 4.8, IC = [1.15, 20.34], p = 0.021 for testosterone , OR = 1.4, IC = [1.05, 1.81], p = 0.02 for Δ4A, and OR = 1.03, IC = [1.01, 1.06], p = 0.015 for the time to conceive). There was no difference in terms of obstetric complications between treated and untreated pregnancies. Genetic status had no impact on pregnancy outcome or time to conceive, although patients with severe mutation had a more symptomatic presentation than patients without. Discussion: infertility is relative in patients with NCAH. As part of a desire for pregnancy, HC seems beneficial, especially for patients with menstrual disorders and high levels of androgen preconceptional.
Document type :
Master Thesis
Complete list of metadata

https://dumas.ccsd.cnrs.fr/dumas-03129832
Contributor : Université Paris Descartes - Scd Connect in order to contact the contributor
Submitted on : Wednesday, February 3, 2021 - 10:04:34 AM
Last modification on : Wednesday, June 2, 2021 - 3:25:08 AM

File

ThExe_CARRIERE_Camille_DUMAS.p...
Files produced by the author(s)

Licence


Distributed under a Creative Commons Attribution - NonCommercial - NoDerivatives 4.0 International License

Identifiers

  • HAL Id : dumas-03129832, version 1

Citation

Camille Carrière. Étude de la fertilité et des grossesses dans une cohorte de femmes présentant une hyperplasie congénitale des surrénales par déficit en 21-hydroxylase de forme non classique. Médecine humaine et pathologie. 2019. ⟨dumas-03129832⟩

Share

Metrics

Record views

12

Files downloads

165