Autoimmune Infertility and DES
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Posted by Elaine Moore Sep 3, 2007 |
Millions of young adults were exposed to diethylstilbestrol (DES) during their mothers' pregnancies. DES exposure causes increased rates of miscarriage, ectopic pregnancy, premature birth and infertility.
Who is at Risk?
The CDC advises that adult children learn the medical history of their parents and grandparents. While the risk for DES Daughters and DES Sons are well documented and still being studied, the risks for third generation offspring of DES parents are still being studied.
DES Daughters
DES daughters who present for infertilty evaluation should undergo a hysterosalpingogram to assess for upper genital tract abnormalities. The T-shaped uterus is the most common abnormality seen.
Several studies report poor reproductive performance in DES-exposed daughters with a range of 34% to 75% for successful pregnancy outcomes. Women exposed to DES in utero are at increased risk for pre-term labor, ectopic pregnancy, and first- and second-trimester spontaneous pregnancy losses. Exposed women run a three to five times greater risk of an ectopic pregnancy and a 2-4 times higher risk of miscarriage than unexposed women.
Pregnancy problems are associated primarily with an increased risk for pre-term delivery. According to studies, approximately 20% of women exposed in utero to DES had pre-term births in comparison with only 8% of unexposed women.
Studies conducted since 1970 link genital tract abnormalities caused by in utero DES exposure to poor reproductive performance, specifically uterine contractility or cervical incompetence. Studies show that women with upper genital tract lesions associated with DES exposure had worse reproductive outcomes than women with normal uterine anatomy.
DES Sons
Although early studies showed no increase in infertility among DES sons, recent evidence suggests that infertility is increased among the sons exposed to DES in utero. Structural abnormalities, testicular problems and other gonadal problems are also known to occur.
National Cancer Institute, DES Daughters
DES Action, Sons Exposed to DES