No birth children for me either, despite years of trying. My CAH sister also didn’t ever conceive. Our non-CAH sister and brothers, as well as female cousins had no trouble at all becoming pregnant. Suspicious...I think so!

Like Brenda, in my case all other possible normal causes for infertility were eliminated, such as tubal blockage - PID, husband factors etc. Ovulation for me was never very convincing though...quite spasmodic. According to my reproductive endo I did not have PCOS.

However when I had a hysterectomy the report stated that the uterus was large and the lining showed various features of abnormality “as is seen with exogenous hormone therapy”. So I often wonder whether the effects of longterm steroids for me (and sometimes very high doses as a child) produced an effect or hostile environment in the uterus that prevented implantation of an embryo.

I have read in medical literature suggestions that a high progesterone level (in the aldosterone pathway) could be a significant reason for infertility in CAH. It seems that these high levels cannot be controlled by corticosteroids alone. I don’t know therefore if mineralocorticoids are meant to help bring progesterone levels down. Because I am an SV I was never put on florinef even though I showed some salt wasting tendencies and rapid dehydration when ill....it was simply not done when I was younger.

So perhaps for me my infertility was a combination of these CAH and steroid induced factors of spasmodic ovulation, affected uterus/uterine lining and high progesterone levels.

Ability to get pregnant in a healthy person depends on a relatively smooth working of all the correct factors. CAH people (females particularly) have potential for there to be a number of aberrant factors happening at once. So maybe the reason why some CAH people can get pregnant easily and others not, depends on how many of these mitigating factors co-exist. If there are only one or two issues then infertility may be surmounted if not naturally then with reproductive technologies.

If I were you guys with young children I wouldn’t be that worried. I’m sure that with more fine-tuned treatment -lower doses generally, a better understanding of levels (not trying to oversuppress) and even more improved repro technologies your girls will be just fine, (assuming a pregnancy is what they want to achieve).