{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T22:46:29Z","timestamp":1790635589473,"version":"4.1.0"},"reference-count":20,"publisher":"The Endocrine Society","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Context: Testicular adrenal rest tumors (TARTs) are regarded to contribute to the high prevalence of subfertility in males with congenital adrenal hyperplasia (CAH).<\/jats:p><jats:p>Objectives: Our objectives were to evaluate reduced fecundity and its possible causes in well-controlled adult males with CAH, and to investigate diagnostic tools for improved treatment monitoring with respect to fertility outcomes.<\/jats:p><jats:p>Design: In a cross-sectional study at the Department of Endocrinology at the University Hospital Mu\u0308nchen, Germany, 22 adult male CAH patients (15 salt wasting and seven simple virilizing, age 19\u201348 yr) were clinically assessed according to their hormonal control. We performed testicular ultrasound (22 of 22), magnetic resonance imaging (18 of 22), and a semen analysis (19 of 22) in the participants.<\/jats:p><jats:p>Results: All patients had a pathological semen analysis. TART prevalence was 10 of 22 (eight salt wasting, two simple virilizing). Poor therapy control was present in five patients, and all five had TARTs. Of the other 17 well-controlled patients with normal or suppressed adrenal androgens and 17-hydroxyprogesterone levels, five presented with TARTs. There was a significant correlation between sperm concentration and functional testicular volume (r = 0.70; P = 0.002), TART volume (r = \u22120.70; P = 0.036), as well as inhibin B levels (r = 0.75; P &amp;lt; 0.0001), respectively. In several men, hormonal control parameters suggested hypogonadism, with glucocorticoid overtreatment as a relevant factor for poor semen quality.<\/jats:p><jats:p>Conclusions: Poor semen parameters are common in male CAH patients. TARTs, most likely reflecting undertreatment, as well as inhibin B are important indicators of fecundity. On the other hand, long-term glucocorticoid overtreatment also seems to contribute to low semen quality.<\/jats:p>","DOI":"10.1210\/jc.2008-1414","type":"journal-article","created":{"date-parts":[[2009,3,4]],"date-time":"2009-03-04T03:04:07Z","timestamp":1236135847000},"page":"1665-1670","source":"Crossref","is-referenced-by-count":137,"title":["High Prevalence of Reduced Fecundity in Men with Congenital Adrenal Hyperplasia"],"prefix":"10.1210","volume":"94","author":[{"given":"Nicole","family":"Reisch","sequence":"first","affiliation":[{"name":"Endocrinology and Metabolism (N.R., L.F., M.B., F.B., M.Re.), University Hospital Mu\u0308nchen, D-80336 Mu\u0308nchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Flade","sequence":"first","affiliation":[{"name":"Endocrinology and Metabolism (N.R., L.F., M.B., F.B., M.Re.), University Hospital Mu\u0308nchen, D-80336 Mu\u0308nchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Scherr","sequence":"first","affiliation":[{"name":"Medizinische Klinik-Innenstadt, Department of Radiology (M.S.), University Hospital Mu\u0308nchen, D-80336 Mu\u0308nchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marietta","family":"Rottenkolber","sequence":"first","affiliation":[{"name":"Institute of Medical Information Technology, Biometry and Epidemiology (M.Ro.), Ludwig-Maximilians-Universita\u0308t, Mu\u0308nchen D-81377, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Pedrosa Gil","sequence":"first","affiliation":[{"name":"Psychosomatic Ambulance and Outpatient Clinic (F.P.G.), University Hospital Mu\u0308nchen, D-80336 Mu\u0308nchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Bidlingmaier","sequence":"first","affiliation":[{"name":"Endocrinology and Metabolism (N.R., L.F., M.B., F.B., M.Re.), University Hospital Mu\u0308nchen, D-80336 Mu\u0308nchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Wolff","sequence":"first","affiliation":[{"name":"Outpatient Clinic of Andrology, Department of Dermatology (H.W.), University Hospital Mu\u0308nchen, D-80336 Mu\u0308nchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Peter","family":"Schwarz","sequence":"first","affiliation":[{"name":"Department of Endocrinology, von Haunersches Kinderspital (H.-P.S.), University Hospital Mu\u0308nchen, D-80336 Mu\u0308nchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Quinkler","sequence":"first","affiliation":[{"name":"Clinical Endocrinology (M.Q.), Charite\u0301 Campus Mitte, Charite\u0301 University Medicine Berlin, Berlin 13353, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Beuschlein","sequence":"first","affiliation":[{"name":"Endocrinology and Metabolism (N.R., L.F., M.B., F.B., M.Re.), University Hospital Mu\u0308nchen, D-80336 Mu\u0308nchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Reincke","sequence":"first","affiliation":[{"name":"Endocrinology and Metabolism (N.R., L.F., M.B., F.B., M.Re.), University Hospital Mu\u0308nchen, D-80336 Mu\u0308nchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","reference":[{"key":"2020071613151203800_R1","doi-asserted-by":"crossref","first-page":"5721","DOI":"10.1210\/jcem.86.12.8090","article-title":"High prevalence of testicular adrenal rest tumors, impaired spermatogenesis, and Leydig cell failure in adolescent and adult males with congenital adrenal hyperplasia.","volume":"86","author":"Stikkelbroeck","year":"2001","journal-title":"J Clin 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