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Sorry I missed your post first time round. Many people with mild CAH can survive day to day with medication without suffering from severe illness. As stated by Cindy though, in the case of severe trauma, things become much more critical, and he should really be wearing a MedicAlert as well as taking meds in order to avoid issues.
In terms of long term effects with no taking meds, then yes, his fertility could be affected. Reduction in fertility in males due to poor treatment can occur, as can TARTs - testicular adrenal rests. These are BENIGN growths on the testicles from poor treatment, and will usually disappear with time once suitable treatment starts again.
