CAH or congenital adrenal hyperplasia is a disease caused by gene mutation. The condition affects cortisol, cholesterol and adrenal gland function. All CAH patients have some level of impaired fertility. Some patients are unable to get pregnant at all, while others are able to get pregnant but need specialized care during pregnancy. CAH increases progesterone levels, which can have a negative impact on the fetus.
Researchers from Children's Hospital of Pittsburgh recently published a review in the journal Current Opinion in Endocrinology, Diabetes and Obesity on the disease's impact on fertility and pregnancy. According to study authors, suppressing progesterone is necessarily before conception to boost fertility. After pregnancy, treatments need to be personalized to each patient to support a healthy pregnancy. With individualized care, patients with CAH can have an uneventful pregnancy and ending in live birth with no negative impact on the fetus.
Source: Witchel SF. Management of CAH during pregnancy: optimizing outcomes. Curr Opin Endocrinol Diabetes Obes. 2012 Oct 25.