scholarly journals Two cases of reversible male infertility due to congenital adrenal hyperplasia combined with testicular adrenal rest tumor

2017 ◽  
Vol 17 (1) ◽  
pp. 93-97 ◽  
Author(s):  
Mikito Tanaka ◽  
Noritoshi Enatsu ◽  
Koji Chiba ◽  
Masato Fujisawa
Keyword(s):  
Male Infertility ◽  
Congenital Adrenal Hyperplasia ◽  
Adrenal Hyperplasia ◽  
Adrenal Rest Tumor ◽  
Adrenal Rest ◽  
Testicular Adrenal Rest

UP-2.054: Testicular Adrenal Rest Tumor in Infertile Patient with Congenital Adrenal Hyperplasia

Urology ◽  
2009 ◽  
Vol 74 (4) ◽  
pp. S248-S249
Author(s):  
G. Marchini ◽  
B. Wagner ◽  
F. Ortega ◽  
M. Cocuzza ◽  
M. Srougi ◽  
...  
Keyword(s):  
Congenital Adrenal Hyperplasia ◽  
Adrenal Hyperplasia ◽  
Infertile Patient ◽  
Adrenal Rest Tumor ◽  
Adrenal Rest ◽  
Testicular Adrenal Rest

scholarly journals Individualizing Management of Infertility in Classic Congenital Adrenal Hyperplasia and Testicular Adrenal Rest Tumors

2019 ◽  
Vol 3 (12) ◽  
pp. 2290-2294 ◽  
Author(s):  
Smita Jha ◽  
Diala El-Maouche ◽  
Jamie Marko ◽  
Ashwini Mallappa ◽  
Padmasree Veeraraghavan ◽  
...  
Keyword(s):  
Male Infertility ◽  
Congenital Adrenal Hyperplasia ◽  
Semen Analysis ◽  
Glucocorticoid Therapy ◽  
Seminiferous Tubules ◽  
Adrenal Hyperplasia ◽  
Classic Congenital Adrenal Hyperplasia ◽  
Testicular Adrenal Rest Tumors ◽  
Adrenal Rest ◽  
Testicular Adrenal Rest

Abstract Testicular adrenal rest tumors (TARTs) are a common cause of male infertility in patients with classic congenital adrenal hyperplasia (CAH). These tumors are located in the rete testis and can lead to impaired blood flow and functional impairment of seminiferous tubules. We describe restoration of fertility in a man with CAH and bilateral TARTs with use of lower-dose glucocorticoid therapy than previously described. A 28-year-old man with classic salt-wasting CAH presented with impaired fertility. Biochemical evaluation showed poor CAH control despite reported compliance with prednisone 5 mg every morning and fludrocortisone 50 μg twice daily. Semen analysis showed azoospermia. Testicular ultrasonography showed TARTs occupying 16% of total testicular volume. After 5 months of dexamethasone 250 μg at bedtime, total TART volume decreased 90%, biochemical control improved, and semen analysis showed a sperm count of 132 × 106 million per milliliter. The patient’s wife was confirmed to be pregnant 9 months after the initial visit and delivered a healthy full-term baby girl. The patient’s glucocorticoid therapy was changed to prednisone 3 mg twice daily, and 2 years later he continues to show adequate CAH control, stable TART volume, and normal semen analysis, and his wife is pregnant again. Management of CAH in men with TARTs needs to be individualized, and high-dose dexamethasone may not be indicated. The use of a long-acting glucocorticoid at typical recommended dosages can decrease TART size and reverse male infertility. Prednisone given once daily does not adequately control the ACTH-driven complications of CAH.

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