Modified-release hydrocortisone for female fertility in congenital adrenal hyperplasia
Authors' conclusion
MRHC improved hormonal control and was associated with restoration of menstrual cyclicity and high rates of spontaneous conception with a lower HDE.
Study context
- Population
- Women with classic congenital adrenal hyperplasia (CAH) and menstrual irregularities or unfulfilled desire to have children despite conventional GC therapy (median 4 years), including assisted reproduction
- Participants
- 8 women
- Exposure
- Modified-release hydrocortisone (MRHC) vs conventional GC therapy
- Outcome
- Morning serum hormones
Methodological detailsbefore-after switch
- Before-after switch
Main finding
As reported in the abstract
| Group | Value | 17OHP (ng/dl) | Androstenedione (ng/dL) | Testosterone (ng/dL) |
|---|---|---|---|---|
| MRHC | median 0.9 ng/mL progesterone | 49.0 | 76.0 | 27.0 |
| Conventional GC | median 2.1 ng/mL progesterone | 131.5 | 261.0 | 63.0 |
Value
MRHCmedian 0.9 ng/mL progesterone
Conventional GCmedian 2.1 ng/mL progesterone
17OHP (ng/dl)
MRHC49.0
Conventional GC131.5
Androstenedione (ng/dL)
MRHC76.0
Conventional GC261.0
Testosterone (ng/dL)
MRHC27.0
Conventional GC63.0
Observational data: associations, not effects.
Further findings
Median hydrocortisone dose equivalent (HDE) · after switching to MRHC vs before
- Lower median HDE after switching to MRHC vs before
- 30.0 v. 32.5 mg/d
- Descriptive analysis
Salivary 17OHP profiles, median AUC · after switching to MRHC vs before
- Trend towards lower median AUC after switching to MRHC vs before
- 183.9 vs. 676.5 pg × t(n)/mL
- Lower salivary 17OHP concentrations across all time points
Original publication
Modified-release hydrocortisone for female fertility in congenital adrenal hyperplasia. J Clin Endocrinol Metab. Published 28 July 2026. doi:10.
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