Males Exposed In Utero to Diethylstilbestrol

Leary, Frank J.

doi:10.1001/jama.1984.03350210032025

Cited by 64 publications

(9 citation statements)

References 17 publications

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“…A potential problem with any such study (whether in humans or animals) is fetal exposure to DES after the critical period of reproductive tract development. Records of DES doses and durations of exposure in this cohort reveal that the 25th and 50th percentiles of the first gestational day of exposure were on days 54 and 89, with exposure durations of 28 and 100 days, respectively [24]. Therefore, the timing of DES exposure is well within the window during which development of the reproductive tract is occurring.…”

Section: Effects Of Des In Humansmentioning

confidence: 71%

“…These studies suggest that certain maternal DES dosing regimens were not sufficient to result in certain adverse effects to offspring exposed in utero. For example, a study conducted on a cohort from the Mayo Clinic, which appears to have employed the lowest DES dosing schedule of any clinical center in the United States, demonstrates a mean no effect maternal dose level for effects attributable to in utero DES exposure [24]. This study was designed to determine if men exposed in utero to DES had a higher frequency of urogenital abnormalities than an unexposed control group.…”

Section: Effects Of Des In Humansmentioning

confidence: 99%

“…This study was conducted on a cohort of men exposed in utero to DES according to the dosing protocol in use at the University of Chicago where mean total maternal DES dosages were, on average, 11,603 mg. Another small study reported lower average sperm counts in 20 DES-exposed men and pathologic Eliasson scores in 18 DES-exposed men, but no comparison controls were used, and maternal DES dosages were unknown [19]. In contrast, in a cohort of men from the Mayo Clinic exposed in utero to DES in which total mean maternal DES doses were approximately 1.4 g, there were no differences between 110 DES-exposed men and unexposed men in sperm count, motility, or abnormal Eliasson scores [24].…”

Section: Decreased Sperm Qualitymentioning

confidence: 99%

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The possible effects of environmental estrogen disrupters on reproductive health

2000

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The term environmental estrogen refers to chemical substances that exhibit some degree of estrogen-like activity. The primary emphasis for potential adverse effects resulting from exposure to environmental estrogens is on in utero exposure because such exposures can occur during critical periods of organogenesis. Assessment of biological plausibility can be based, in part, on the extensive data on the effects of diethylstilbestrol (DES). The available evidence is too limited to judge with any confidence whether sperm counts have declined during the past 50 years. Based on both animal and human data with DES, it is biologically plausible that in utero exposures to exogenous estrogenic compounds are capable of reducing sperm production in adult men. However, the apparent existence of a maternal dose threshold for DES-induced effects on sperm count undermines the likelihood that environmental estrogens, which are substantially less potent, are capable of causing similar effects.

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Section: Effects Of Des In Humansmentioning

confidence: 71%

Section: Effects Of Des In Humansmentioning

confidence: 99%

Section: Decreased Sperm Qualitymentioning

confidence: 99%

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The possible effects of environmental estrogen disrupters on reproductive health

2000

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“…The latter study reported that men exposed as fetuses to DES had an over threefold increased risk for developing TC, although this elevated risk estimate was imprecise and did not reach statistical significance. In utero exposure to DES was associated with reduced testicular size and reduced semen quality and increased frequency of genital abnormalities (Gill et al, 1977(Gill et al, , 1979Wilcox et al, 1995), although not consistently (Leary et al, 1984), suggesting that the reported enhanced risk of TC stems from dysgenesis of testis development.…”

Section: Prenatal Influencesmentioning

confidence: 95%

Testicular Cancer and Hormonally Active Agents∗

Garner

Turner

Ghadirian

et al. 2008

Journal of Toxicology and Environmental Health, Part B

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Testicular cancer (TC) is a rare form of cancer, accounting for 1% of all new cancer cases in Canadian males. TC is the most common malignancy among young men, aged 25-34 yr old. Over previous decades, the incidence of TC has increased in many Western countries. Countries with a sufficiently long period of cancer registration, such as Denmark, document this trend back to the first half of the 20th century. The etiology of TC remains poorly understood. Most of the established risk factors are likely related to in utero events, including some factors that are purported to be surrogate measures for exposure to endogenous estrogens. The correlation of TC with other testicular abnormalities and with pregnancy factors led to the proposal that these conditions are a constellation of sequelae of impairment of testicular development called testis dysgenesis syndrome. There is some limited evidence suggesting that exposure to pharmacological estrogens may contribute to some cases of TC. There is currently no compelling evidence that exposure to environmental estrogenic or other hormonally active substances is contributing to the rise in TC incidence observed in Western nations over the last several decades; however, this question has not been extensively studied. The (1) rarity of this condition in the population, (2) long lag time between the presumed sensitive period during fetal development and clinical appearance of the condition, and (3) lack of a good animal model to study the progression of the disease have greatly hindered the understanding of environmental influences on TC risk.

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“…Since the documented association with CCA, DES has also been linked to structural and functional reproductive tract anomalies, infertility, vaginal epithelial changes and adverse pregnancy outcomes in DES daughters (women exposed in utero) (Guisti et al, 1995;Sharp, Cole, Anderson, & Herbst, 1990), genital abnormalities in DES sons (men exposed in utero) (Leary et al, 1984), and a slight increased risk of breast cancer in DES mothers (women who took DES during pregnancy) (Colton et al, 1993). Other suspected health effects of exposure, including testicular cancer and autoimmune disorders, are under investigation (Guisti et al, 1995).…”

mentioning

confidence: 99%

Exposure to Diethylstilbestrol: Design of a Multilevel Community Intervention

Duke

McGraw

Avis

2000

Health Promotion Practice

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iethylstilbestrol (DES), a synthetic estrogen, was prescribed to pregnant women as early as 1938. Based on limited clinical observations and speculation about its biochemical mechanisms, prescription of DES was adopted by physicians in many areas of the country under the erroneous expectation that it would prevent miscarriage and produce a healthier pregnancy (Guisti, Iwamoto, & Hatch, 1995; Wingard, Cohn, Helmrich, & Edelstein, 1996). Although no beneficial effect was observed in a large clinical trial reported in 1953 (Dieckmann, Davis, Rynkiewicz, & Pottinger, 1953), DES during pregnancy continued to be prescribed. The first report documenting the association between in utero exposure and the development of clear cell adenocarcinoma (CCA) in women 14 to 22 years old was published in 1970 (Herbst & Scully, 1970). CCA (a rare cancer of the vagina and cervix) had previously been seen only in elderly women. With additional reports of clear cell cancer in young women exposed in utero (Greenwald, Barlow, Nasca, & Burnett, 1971), the use of DES with pregnant women was contraindicated in

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Males Exposed In Utero to Diethylstilbestrol

Cited by 64 publications

References 17 publications

The possible effects of environmental estrogen disrupters on reproductive health

The possible effects of environmental estrogen disrupters on reproductive health

Testicular Cancer and Hormonally Active Agents∗

Exposure to Diethylstilbestrol: Design of a Multilevel Community Intervention

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