Time to Pregnancy and Secondary Sex Ratio in Men Exposed Prenatally to Diethylstilbestrol

L. A. Wise, L. Titus-Ernstoff, J. R. Palmer, R. N. Hoover, E. E. Hatch, K. M. Perez, W. C. Strohsnitter, R. Kaufman, D. Anderson, R. Troisi
2007 American Journal of Epidemiology  
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
more » ... 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 ¼ 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. diethylstilbestrol; estrogens; fertility; males; reproduction; sex ratio Abbreviations: CI, confidence interval; DES, diethylstilbestrol; FR, fecundability ratio. Diethylstilbestrol (DES) is a synthetic estrogen that was prescribed for over 2 million pregnant women during the 1940s-1960s to prevent pregnancy loss. Prenatal DES exposure in the daughters of these women has been associated with several adverse reproductive events, including vaginal and cervical clear cell adenocarcinoma (1), reproductive tract anomalies (2, 3), infertility (4, 5), and poor pregnancy outcomes (4, 6). Studies in men provide mixed results regarding the association between prenatal DES exposure and reproduction. Prenatal DES exposure is associated with an excess rate of structural and functional malformations of the male Downloaded from https://academic.oup.com/aje/article-abstract/166/7/765/94534 by guest on 30 July 2018 Prenatal DES Exposure and Reproductive Outcomes in Men 769 Am J Epidemiol 2007;166:765-774 Downloaded from https://academic.oup.com/aje/article-abstract/166/7/765/94534 by guest on 30 July 2018 * DES, diethylstilbestrol. y Adjusted for cohort, paternal age, calendar year, and birth order. z Two-sided p value from a likelihood ratio test comparing models with and without interaction terms between each polytomous categorical variable and DES exposure. § Odds ratio for a male birth comparing the exposed with the unexposed. Prenatal DES Exposure and Reproductive Outcomes in Men 771 Am J Epidemiol 2007;166:765-774 Downloaded from https://academic.oup.com/aje/article-abstract/166/7/765/94534 by guest on 30 July 2018 z Combined cohorts were adjusted for cohort, paternal age, calendar year of the child's birth, and birth order. Individual cohorts were adjusted for paternal age, calendar year, and birth order. § Odds ratio for a male birth comparing the selected exposure group with the unexposed. 772 Wise et al. Am J Epidemiol 2007;166:765-774
doi:10.1093/aje/kwm136 pmid:17596265 fatcat:cg67o7duqne4rfgh65vuqbf4wu