Effect of diethylstilbestrol on reproductive function, Fertility and sterility, NCBI PubMed PMID: 10428139, 1999 Jul.
Full text: FERTILITY AND STERILITY, Volume 72, Issue 1, Pages 1–7 S0015-0282(99)00153-3, July 1999.
To review the effects of in utero exposure to diethylstilbestrol (DES) on müllerian development and subsequent reproductive function.
The literature on DES and reproductive function was reviewed and summary data are presented. The studies were identified through the computerized MEDLINE database and a manual search of relevant bibliographies.
In utero exposure to DES resulted in
- reduced fertility
- and increased rates of ectopic pregnancy,
- spontaneous abortion,
- and preterm delivery.
In the wake of the DES and thalidomide tragedies, the effect of new pharmaceuticals on pregnancy is now considered and medications are used more judiciously during pregnancy. The anatomic changes associated with exposure to DES in utero are well known even though the pathogenic mechanisms are not.
Although new cases of vaginal clear cell adenocarcinoma resulting from exposure to DES in utero are not expected at this point, an unknown number of exposed women are still facing several reproductive hazards in their quest for a viable live birth. These patients must be observed closely for ectopic pregnancy, spontaneous abortion, and PTD. In spite of their poor obstetric histories, they can be reassured that approximately 80% ultimately will be successful. Surgical correction of the structural abnormalities in an attempt to improve their reproductive performance is not advised. The use of prophylactic cervical cerclage may be beneficial, but a consensus is lacking.
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