In adult women with NCCAH, is there a benefit in using supratherapeutic doses of prednisone in addition to clomiphene to improve fertility rates?

In NC-CAH, subfertility is mild compared with the classical form. Most women with nonclassic 21-hydroxylase deficiency have normal ovulation and ability to conceive, but miscarriages occur in up to 25% of their pregnancies. In women with NC-CAH who are infertile or have a history of prior miscarriage, treatment with 15 to 25 mg of hydrocortisone daily, started before conception and continued until term, is associated with lower rates of miscarriage. Androgen levels (Test and A4) may be used to t...