ABSTRACT
Little is known about the influence of prenatal diethylstilbestrol (DES) exposure on time to pregnancy or secondary sex ratio in men. The authors evaluated these associations among men participating in the DES Combined Cohort Follow-up Study for whom exposure status was confirmed by medical record. In 2001, men provided data on their reproductive histories. Demographic, behavioral, and medical data were collected in 1994, 1997, and 2001. Cox's proportional hazards models with frailty were used to estimate fecundability ratios for time to pregnancy in relation to DES. Generalized estimating equations were used to estimate odds ratios for fathering a male birth in relation to DES. Models included potential confounders and accounted for multiple pregnancies contributed by each man. Overall, DES was not associated with a delay in time to pregnancy (fecundability ratio = 0.95, 95% confidence interval: 0.86, 1.06). The odds ratio for fathering a male birth was 0.92 (95% confidence interval: 0.80, 1.04) comparing the exposed with the unexposed. In conclusion, prenatal DES exposure was not associated with a significant decrease in either fecundability or secondary sex ratio.
Subject(s)
Diethylstilbestrol/adverse effects , Estrogens, Non-Steroidal/adverse effects , Estrogens/toxicity , Genitalia, Male/drug effects , Infertility, Female/drug therapy , Prenatal Exposure Delayed Effects , Sex Ratio , Adult , Confidence Intervals , Female , Humans , Infertility, Male/chemically induced , Male , Odds Ratio , Pregnancy , Proportional Hazards Models , Reproductive History , Surveys and Questionnaires , Time FactorsABSTRACT
OBJECTIVE: To examine prenatal diethylstilbestrol (DES) exposure in relation to male reproductive outcomes. DESIGN: Prospective observational study. SETTING: Participants were identified through record review, clinical trial participation, or an obstetrics clinic. PATIENT(S): A total of 1,085 DES-exposed and 1,047 unexposed men. INTERVENTION(S): Participants were exposed prenatally to DES through the mother's obstetrics care or clinical trial participation. MAIN OUTCOME MEASURE(S): Infertility; never fathering a pregnancy or live birth; number of pregnancies or live births fathered. RESULT(S): We found little evidence that prenatal DES exposure affects the likelihood of never fathering a pregnancy or live birth, or influences the mean number of fathered pregnancies or live births. Our data suggest that DES-exposed men are slightly more likely to experience infertility (relative risk [RR] = 1.3, 95% confidence interval [CI] = 1.0-1.6). The DES dose and gestational timing did not influence infertility or the number of pregnancies or live births fathered, but results were inconsistent for dose effects on the likelihood of never fathering a pregnancy or a live birth. CONCLUSION(S): Prenatal DES exposure may be associated with a slightly increased risk of having an infertility experience, but does not increase the likelihood of never fathering a pregnancy or a live birth, or the number of pregnancies or live births fathered.
