Diethylstilbestrol DES and Pregnancy Studies

~ Perhaps no drug has been more praised or more damned during the past 3 years than diethylstilbestrol (DES, stilbestrol) ~
1974 quote

Well,

• how can, the exact same drug, be sold and used during the exact same decades (1960s and 1970s), for two fundamentally opposite goals : to prevent miscarriage AND as a contraceptive? Should it not be one or the other?
• And how can a drug be considered safe, when there are warnings about its toxicity?
• And how can a drug be officially (re)approved for usage when its carcinogenic effects are known and proven?

New Generations (People exposed in-Utero)

Pregnancy Outcome in DES Offspring
and Implications for Childbearing

• 2019 Reproductive and hormone-related outcomes in women whose mothers were exposed in utero to diethylstilbestrol (DES): A report from the US National Cancer Institute DES Third Generation Study.
• 2018 Demographic, lifestyle, and reproductive risk factors for ectopic pregnancy.
• 2018 Hysteroscopic enlargement metroplasty for T-shaped uterus: 24 years’ experience at the Strasbourg Medico-Surgical and Obstetrical Centre (CMCO).
• 2016 vidéo Conséquences pour les mères, filles et fils DES.
• 2013 Exposure to Diethylstilbestrol during Sensitive Life Stages: A legacy of heritable health effects.
• 2013 Hysteroscopic metroplasty for the septate uterus: review and meta-analysis.
• 2011 Adverse health outcomes in women exposed in utero to diethylstilbestrol.
• 2011 Surgical approach to and reproductive outcome after surgical correction of a T-shaped uterus.
• 2011 Term delivery rate after hysteroscopic metroplasty in patients with recurrent spontaneous abortion and T-shaped, arcuate and septate uterus.
• 2009 Effects of exposure period and dose of diethylstilbestrol on pregnancy in rats.
• 2007 Diethylstilbestrol exposure in utero. Polemics about metroplasty. The cons.
• 2007 Preeclampsia risk in women exposed in utero to diethylstilbestrol.
• 2005 Early prophylactic cervical cerclage for hypoplastic cervix following exposure to DES in utero.
• 2001 Effects of Mullerian anomalies on in vitro fertilization outcome.
• 2000 Continued follow-up of pregnancy outcomes in diethylstilbestrol-exposed offspring.
• 1999 Effect of diethylstilbestrol on reproductive function.
• 1997 Outcome of IVF in DES-exposed daughters: experience in the 90s.
• 1996 Beneficial effect of hysteroscopic metroplasty on the reproductive outcome in a T-shaped uterus.
• 1996 Endometrial pattern in diethylstilboestrol-exposed women undergoing in-vitro fertilization may be the most significant predictor of pregnancy outcome.
• 1996 Hysteroscopic metroplasty for uterine enlargement: a treatment for diethylbestrol-exposed and hypoplastic uteri.
• 1996 Transvaginal ultrasound studies of vascular and morphological changes in uteri exposed to diethylstilbestrol in utero.
• 1995 Effect of diethylstilbestrol or zeranol on fetal development, gestation duration, and number of offspring in NMRI mice.
• 1995 Pregnancy after transposition and repositioning of the ovaries in a patient with clear-cell adenocarcinoma.
• 1992 DES exposure: implications for childbearing.
• 1991 Cervical cerclage in early pregnancy.
• 1991 Refocusing on the gynecological and obstetrical consequences of intrauterine exposure to diethylstilbestrol (DES).
• 1990 Are implantation and pregnancy outcome impaired in diethylstilbestrol-exposed women after in vitro fertilization and embryo transfer?
• 1989 Ultrasound surveillance of the cervix during pregnancy in diethylstilbestrol-exposed offspring.
• 1988 Adverse outcomes of pregnancy in women exposed to diethylstilbestrol in utero.
• 1988 Outcome of pregnancy in patients exposed in utero to diethylstilbestrol. Survey by the National College of French Gynecologists and Obstetricians.
• 1988 Pregnancy after gamete intrafallopian transfer in a woman with primary infertility and in utero exposure to diethylstilbestrol. A case report.
• 1987 Management of the diethylstilbestrol-exposed pregnant patient: a prospective study.
• 1984 Experience with diethylstilbestrol-exposed infertile women in a program of in vitro fertilization.
• 1983 Complications of pregnancy in mice exposed prenatally to DES.
• 1983 Exposure to diethylstilbestrol during intrauterine life. Signs that should suggest this. Therapeutic implications.
• 1983 The clinical management of repeated early pregnancy wastage.
• 1982 Pregnancy Outcome in 98 Women Exposed to Diethylstilbestrol In Utero, Their Mothers, and Unexposed Siblings.
• 1982 Reproductive performance of DES-exposed-female progeny. Consequences of diethylstilbestrol in women whose mothers ingested the substance during pregnancy.
• 1981 Pregnancy outcome in women exposed to diethylstilbestrol in utero.
• 1981 Reproductive and gynecologic surgical experience in diethylstilbestrol-exposed daughters.
• 1981 Reproductive performance of DES-exposed female progeny.
• 1981 Structure and function of the fallopian tubes following exposure to diethylstilbestrol (DES) during gestation.
• 1980 A comparison of pregnancy experience in DES-exposed and DES-unexposed daughters.
• 1980 Placental changes due to administration of diethylstilbestrol (DES).
• 1980 Reproductive Outcome of Women exposed to Diethylstilbestrol In Utero.
• 1980 Reproductive problems in the DES-exposed female.
• 1980 Upper genital tract changes and pregnancy outcome in offspring exposed in utero to diethylstilbestrol.

Direct Usage and Exposure

DES used as an Emergency Contraception

• 2013 Kenyan women using animal abortion pills (Kenya).
• 2011 Pioneering Studies of the “Morning-After” Pill.
• 1999 Diethylstilbestrol and Media Coverage of the “Morning After” Pill.
• 1995 Expanding access to emergency contraception in developing countries.
• 1995 Postcoital contraception: present and future options.
• 1994 Emergency contraception: a review (The Netherlands).
• 1992 Postcoital contraception underrecognized and underutilized.
• 1991 The future of hormonal contraception.
• 1990 Must a Catholic hospital inform a rape victim of the availability of the “morning-after pill“?
• 1990 Post-ovulatory contraception.
• 1989 Pharmacist’s refusal to dispense diethylstilbestrol for contraceptive use.
• 1985 Estrogen treatment for victims of rape.
• 1985 Post-coital contraception (France).
• 1984 Contraception – the morning after.
• 1984 Postcoital contraception (without prostaglandins) (Germany).
• 1983 Postcoital contraception.
• 1983 Postcoital contraception (Denmark).
• 1983 The morning after: novel hormonal approaches to postcoital interception.
• 1982 Contraception in adolescence,
• 1981 Estrogens and postcoital contraception.
• 1981 Postcoital contraception (The Netherlands).
• 1980 Ovral touted as morning-after pill.
• 1979 Emotional distress in morning-after pill patients.
• 1978 Delayed adverse effects of contraceptives (Hungary).
• 1978 Estrogen Use in Children and Adolescents: A Survey.
• 1978 Physician notes hazards of DES use to prevent pregnancy.
• 1977 Postcoital contraceptives in clinical practice (Czechoslovakia).
• 1977 The “Morning-After Pill“.
• 1977 The Use of Oestrogens for Postcoital Contraception (United Kingdom).
• 1976 Are Oral Contraceptives and Diethylstilbestrol (DES) Involved in Sex-Linked Cancer?
• 1976 Diethylstilbestrol in the Treatment of Rape Victims.
• 1976 Letter: Ectopic pregnancy after postcoital diethylstilbestrol.
• 1976 Our experience with “morning-after-pill” (Czechoslovakia).
• 1975 Copper IUD, inserted after coitus averts pregnancy and provides continuing contraceptive protection.
• 1975 Development of the oral contraceptives.
• 1975 Ectopic pregnancy after postcoital diethylstilbestrol.
• 1975 Total health needs of the rape victim.
• 1974 Diethylstilbestrol Usage: Its Interesting Past, Important Present, and Questionable Future – Morning-After Contraception.
• 1974 Oestrogen interception: the morning-after pill.
• 1974 Postcoital contraception with diethylstilbestrol – updated.
• 1974 The Stilbestrol Story.
• 1973 Diethylstilbestrol as a “morning after” contraceptive.
• 1973 FDA considers DES safe as ‘morning-after’ pill.
• 1973 Interception: the use of postovulatory estrogens to prevent implantation.
• 1973 Letter: The “morning after” pill.
• 1973 Possibility of postconception control of fertility using medicamentous nidation inhibitors.
• 1973 Postcoital Diethylstilbestrol Selected Item from the FDA Drug Bulletin – May 1973.
• 1973 The use of estrogens as postcoital contraceptive agents. Clinical effectiveness and potential mode of action.
• 1972 How Soon Will We Have the “Ideal” Contraceptive?
• 1972 Postcoital antifertility agents.
• 1972 Post-coital Contraception.
• 1972 Post-coital oestrogen in large doses.
• 1971 Postcoital Contraception With Diethylstilbestrol.
• 1971 The “morning-after pill“.
• 1970 Endometrial Carbonic Anhydrase After Diethylstilbestrol as a Postcoital Antifertility Agent.
• 1970 Postcoital Contraception.
• 1969 The “morning-after pill“, a preliminary report.
• 1967 Postcoital contraception.
• 1966 Compounds interfering with ovum implantation and development – The role of estrogens.
• 1966 Post-coital oral contraception.
• 1965 Ovulation Control with Stilbestrol.

DES (very wrongly) used to  “Prevent Pregnancy Complications“

• 2003 Oestrogen supplementation, mainly diethylstilbestrol, for preventing miscarriages and other adverse pregnancy outcomes.
• 2001 The DES story: long-term consequences of prenatal exposure, see chapter “DES ineffective for prevention of miscarriage“.
• 1972 Diethylstilbestrol in Pregnancy : Frequency of Exposure and Usage Patterns.
• 1954 The importance of controls in a clinical experiment; stilbestrol therapy in pregnancy.
• 1953 Does the Administration of Diethylstilbestrol during Pregnancy have Therapeutic Value ?.
• 1953 Effect of stilbestrol on pregnancy compared to the effect of a placebo.
• 1952 Diethylstilbestrol tested on pregnant women without their consent, ethical issues of including those women in clinical studies.
• 1951 Use of Diethylstilbestrol in the Treatment of Threatened Abortion.
• 1950 Dosage of Stilbestrol.
• 1949 Diethylstilbestrol dosage in threatened and habitual abortion and premature labor.
• 1949 The influence of diethylstilbestrol on the progress and outcome of pregnancy based on a comparison of treated with untreated primigravidas.
• 1948 Diethylstilbestrol in the prevention and treatment of complications of pregnancy.
• 1942 The Use of Stilbestrol for the Treatment of Threatened and Habitual Abortion and Premature Labor : a Preliminary Report.
• 1941 The Synthetic Estrogen Stilbestrol: an Experimental and Clinical Evaluation.
• 1940 The Action of Diethylstilbestrol in Gynecologycal Dysfunctions.

(Early) Warnings about DES Toxicity

• 2016 Wreaking Reproductive Havoc One Chemical at a Time.
• 1979 Physician Advisory: Health Effects of the Pregnancy Use of Diethylstilbestrol.
• 1978 Dangers of diethylstilboestrol: Review of a 1953 paper.
• 1975 Letter: Birth defects and oestrogens and progesterones in pregnancy.
• 1971 Diethylstilbestrol Contraindicated in Pregnancy Selected Item from the FDA Drug Bulletin – November 1971.
• 1941 Experimental studies on the activity and toxicity of stilbestrol.
• 1940 Clinical Studies on Stilbestrol

For different topics, please see Diethylstilbestrol DES Studies.