DES is an abbreviation used for Diethylstilbestrol. This is a synthetic hormonal therapeutic agent contains non-steroidal estrogen. In 1938, this chemical substance was first introduced. After 1948, DES was used for improving pregnancy outcome, as it had claimed that treatment with DES could increase the production of placental steroidal hormones. But this concept is wrong, which had proven after conduction a large scale clinical trial in 1953. This study result did not find any therapeutic value of DES in reducing fetal wastage, pre-term delivery or pregnancy-induced hypertension.
Later research details had proven that DES increases the spontaneous abortion rate along with an increased rate of preterm delivery and perinatal death. After 1971, DES was banned as it causing adenocarcinoma in a vaginal cell in utero exposure. It has been estimated that two to ten million women had treated with DES to prevent their miscarriage.
Female infertility related to DES exposure
It has suspected that DES-exposed female children or DES daughters may have an abnormal reproductive system, which can cause fallopian tube abnormality, malformation of vagina and uterus. These anatomical abnormalities lead to ovulation disorder, increases risk of miscarriage, ectopic pregnancy, and pre-term delivery. Researchers have explained many possible underlying causes of DES exposure-related reproductive issues:
- DES exposure causes thickening of endometrial in the luteal phase of menstruation. This may associate with insufficient endometrial support require during early conception. A consequence of this may cause infertility or early spontaneous abortion.
- DES exposure causes a higher pulsatility index of the uterine arteries and continue throughout the menstruation cycle and fail to decrease in the luteal phase. The higher pulsatility index of the uterine arteries reduces uterine perfusion with a greater impedance to blood flow. Consequences of this lead to embryo implantation failure, fetal growth retardation, spontaneous abortion, and pregnancy-induced hypertension.
- DES Utero-exposure significantly increases the risk of autoimmune diseases in women, which alter T-cell and natural killer cell function. Alteration of natural killer cell functioning and autoimmune condition like antiphospholipid antibody syndrome have an association with recurrent spontaneous abortion.
- Research findings also supported that DES exposure increases the rate of cesarean section than vaginal delivery. The risk of greater blood loss and the need for manual placental extraction also higher in the case of DES-exposed patients.
- Prolong labor is also common in findings with DES exposure.
Male infertility related to DES exposure
There are not conclusive study findings data available for DES-exposed male children or DES sons. However, the following are some related study findings which explain the consequences of DES exposure to male children:
- Some study findings reported that DES exposure causes abnormal sperm, low sperm counts, anatomical abnormality of urethra and testicles.
- Researchers have also reported that DES exposure increases the risk of non-cancerous epididymal cysts formation on the testicles in DES sons.
- Some male genital abnormalities are suspected to associated with DES exposure include cryptorchidism (undescended testicles), hypospadias (a misplaced opening of the penis), microphallus (smaller than the normal penis).