Dear Adina,

The genetics of CAH are somewhat confusing. First, both parents must be carriers. Each carry 2 genes and pass one to your child. Both you and your husband, if you are both unaffected, will have one cah gene and one non-cah gene. If one of you is affected, then that person will have 2 cah genes. You can have one non-classical and one classical CAH gene, which means that you or your husband could be affected with non-classical cah and be asymptomatic. The symptoms of NCCAH can wax and wane over time, and many live their lives without realizing that they have it. Although I have been told that those who carry one SWCAH gene and one NCCAH gene generally do exhibit some symptoms. This is the only scenario that I can conceive where you could have one child with non-classical CAH and one SWCAH. Furthermore, if indeed you or your husband do carry 2 cah genes, then your future children have a greater chance of being affected with one form of cah or the other--25% chance of SWCAH and 25% chance of NCCAH. Certainly, DNA tests for both of you and possibly an ACTH stimulating test may clear a lot of this up.  Please visit my web site, www.caresfoundation.org for more information. And please, also email me if I can help you in any way, caresfoundation@home.com.

Kelly Leight