The 2005 study results confirm an increased risk of hypospadias when mothers were exposed to DES in utero
BACKGROUND: In 2002, an increased risk of hypospadias was reported for sons of women exposed to diethylstilbestrol (DES) in utero, suggesting transgenerational effects of DES. The aim of this study was to further assess the association between parental DES exposure and hypospadias in a case-referent study.
METHODS: Cases with hypospadias were retrieved from the hospital information system. Referents were recruited via the parents of cases. Both parents completed postal questionnaires. Associations were estimated by odds ratios (OR) with 95% confidence intervals (CI). Additionally, conditional logistic regression analyses were performed for a matched subset of parents.
RESULTS: The final database included 583 cases and 251 referents. In the initial analyses, an indication was found for an increased risk of hypospadias when mothers were exposed to DES in utero: OR=2.3 (95% CI 0.7-7.9). Conditional logistic regression resulted in a stronger risk estimate: OR=4.9 (95% CI 1.1-22.3). Paternal exposure to DES did not increase the risk.
CONCLUSIONS: The results confirm an increased risk of hypospadias when mothers were exposed to DES in utero. However, the excess risk appears to be of much smaller magnitude than in the 2002 study. Further research on the potential health risks for the third generation is of great importance.
NCBI, Hypospadias: a transgenerational effect of diethylstilbestrol?, PMID: 16293648, 2006 Mar;21(3):666-9. Epub 2005 Nov 17.
Oxford Journals, Full Article, Medicine, Human Reproduction, Volume 21, Issue 3, Pp. 666-669., 2005.
Semen quality trends in French regions are consistent with a global change in environmental exposure
A retrospective study carried on a large sample of men close to the general population recently showed a significant and strong decline in sperm concentration and morphology in the whole of France between 1989 and 2005. We studied these trends within each French region.Data were provided from the Fivnat database.
The study sample was constituted by male partners of sterile women whose both tubes were absent or blocked. They were located by assisted reproductive technologies (ART) center.A Bayesian spatio-temporal model with parametric time trends, adjusted for age, was used to model overall time trends for each region.
The results show that sperm concentration decreased in almost all French regions. Aquitaine showed the strongest decrease and Midi-Pyrénées had the lowest average for the whole period.For total motility most regions slightly increased while Bourgogne showed a steep and significant decrease.For normal morphology, most regions decreased. Aquitaine and Midi-Pyrénées showed a stronger decrease than the overall trend.
In conclusion, the decrease in sperm concentration and morphology, already shown at the scale of the French metropolitan territory, was observed in most French regions. This is consistent with a global change in environmental exposure, especially according to the endocrine disruptor hypothesis. Indeed ubiquitary exposure to these chemicals has been growing in the French general population since the fifties and the results don’t seem to support the lifestyle hypothesis. The strongest decreases and lowest values are consistently observed in two proximate regions both highly agricultural and densely populated.
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.
Reproductive Outcomes in Men with prenatal Exposure to DiEthylStilbestrol, NCBI, Dr R Hoover, PMID:16359959, Dec 2005.