The odds of "spontaneous" CAH (where neither parent is a carrier) are very very very very rare. To have CAH, you need to have 2 "bad" or affected genes (one from each parent). The outcome (phenotype) will be the lesser of the 2 evils.  For example, if you’re a carrier you’re fine because one of your genes is normal and makes up for the other "messed up" one. If you have Non-classical CAH  you may have one gene that’s mildly "messed up" and another that’s "totally messed up" (or 2 that are both mild). You will exhibit the more mild case because one of your genes may "sort of" work.  If you have SWCAH, both your genes are "totally messed up."  So, you can only exhibit this most extreme case.  If you’re a Simple-virilizer, your genes are definitely messed up, but not as bad as a salt-waster. 

Does any of this make sense?

So, to have spontaneous SWCAH, something would have to go really wrong with BOTH genes during gamete formation (And that’s very unlikely.)

I would think that spontaneous NCAH is probably more common, but again, is still VERY rare.

Liz, your husband should definitely get tested, especially if you’re planning on having more children.  However, if it ends up that your daughter does, in fact, have CAH, you’ll know that he’s  a carrier (like 99.9% sure).

I will look for a genetics website to explain how recessive traits work.

If you have any questions, please feel free to call me. 1-866-227-3737

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