Abstract
Purpose: The outcome of in vitro fertilization (IVF) in a group of infertile women with a history of in utero exposure to diethylstilbestrol (DES) was analyzed. Records from an academic IVF program were retrospectively reviewed.
Methods: Seventeen infertile women with a self-reported history of exposure to DES in utero, attending the IVF unit at Massachusetts General Hospital (MGH) for assisted reproductive technology (ART), underwent 27 IVF cycles. Analysis of the outcome of IVF including implantation and ongoing pregnancy rates was performed. The data were compared with results from a group of 20 infertile patients with idiopathic infertility undergoing 27 IVF cycles at MGH during the same period. The patients in the two groups were matched for age, basal day 3 levels of follicle stimulating hormone and serum estradiol, and the number and quality of embryos transferred.
Results: The response to controlled ovarian hyperstimulation was comparable in the two groups. Significantly lower implantation and ongoing pregnancy rates following IVF and embryo transfer were seen in the utero DES-exposed group compared to the control patients.
Conclusions: Infertile patients with a history of in utero exposure to DES exhibit a significantly impaired implantation rate following IVF, and the outcome of ART remains poor.
Similar content being viewed by others
REFERENCES
Peress MR, Tsai CC, Mathur RS, Williamson HO: Hirsuitism and menstrual patterns in women exposed to diethylstilbestrol in utero. Am J Obstet Gynecol 1982;144:135–139
Assies J. Hyperprolactinemia in diethylstilbestrol-exposed women [letter]. Lancet 1991;337:983
Bibbo M, Gill WB, Azizi F, Blough R, Fang VS, Rosenfield RL, et al.: Follow-up study of male and female offspring of DES-exposed mothers. Obstet Gynecol 1977;49:l–8
Karande VC, Lester RG, Muasher SJ, Jones DL, Acosta AA, Jones HW: Are implantation and pregnancy outcome impaired in diethylstilbestrol exposed women after in vitro fertilization and embryo transfer? Fertil Steril 1990;54:No. 2
Muasher SJ, Garcia JE, Jones HAW: Experience with diethylstilbestrol-exposed infertile women in a program of in vitro fertilization. Fertil Steril 1984;42:No. 1
Noyes N, Liu HC, Sultan K, Rozenwaks Z: Endometrial pattern in diethylstiboestrol-exposed women undergoing in-vitro fertilization may be the most significant predictor of pregnancy outcome. Hum Reprod 1996;11(12):2719–2723
American Fertility Society: Revised American Fertility Society classification for endometriosis. Fertil Steril 1985;43:351–352
Veeck LL, Wortham JWE Jr, Witmyer J, Sandow BA, Acosta AA, Garcia JE, Jones HW Jr: Maturation and fertilization of morphologically immature human oocytes in a program of in vitro fertilization.Fertil Steril 1983;39:594
Stillman RJ: In utero exposure to diethylstilbestrol: Adverse effects of the reproductive tract and reproductive performance in male and female offspring. Am J Obstet Gynecol 1982;142:No. 7
Sandberg EC, Riffle NC, Higdon JV, Getman CE: Pregnancy outcome in women exposed to diethylstilbestrol in utero. Am J Obstet Gynecol 1981;140:194
Check JH, Nowroozi Km Choe J, Dietterich C: Influence of endometrial thickness and echogenic patterns on pregnancy rates during in vitro fertilization. Fertil Steril 1991;56:1173–1175
Gonen Y, Casper RF: Prediction of implantation by the sonographic appearance of the endometrium during controlled ovarian stimulation for IVF. J Vitro Fert Embryo Transfer 1990;7:146–152
Glissant A, de Mouzon J, Frydman R: Ultrasound study of the endometrium during in vitro fertilization cycles. Fertil Steril 1985;44:786–790
Welker BG, Gembruch U, Diedrich K, Al-Hasani S, Krebs D: Transvaginal sonography of the endometrium during ovum pickup in stimulated cycles for in vitro fertilization. J Ultrasound Med 1989;8:549–553
Salle B, Sergeant P, Awada A, Bied-Damon V, Gaucherand P, Boisson C, Guibaud S, Benchaib M, Rudigoz RC: Transvaginal ultrasound studies of vascular and morphological changes in uteri exposed to diethylstilbestrol in utero. Hum Reprod 1996;11(11):2531–2536
Halling A, Von Mecklenburg C, Forsberg JG: Factors of importance for decreased early embryo survival in female mice treated neonatally with diethylstilboestrol. J Reprod Fertil 1993;99;2:291–297
Castlebaum AJ, Sawin SW, Bellardo LJ, Lessey BA: Endometrial integrin expression in women exposed to diethylstilbestrol in utero. Fertil Steril 1995;63(6):1217–1221
Cohen J, Alikani M, Trowbridge J, Rosenwaks Z: Implantation enhancement by selective assisted hatching using zona drilling of human embryos with poor prognosis. Hum Reprod 1992;7:685–691
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Pal, L., Shifren, J.L., Isaacson, K.B. et al. Outcome of IVF in DES-Exposed Daughters: Experience in the 90s. J Assist Reprod Genet 14, 513–517 (1997). https://doi.org/10.1023/A:1021175326230
Issue Date:
DOI: https://doi.org/10.1023/A:1021175326230