SIDE-EFFECTS OF THERAPEUTICS IN REPRODUCT IVE MEDICINE - THE EXAMPLE OF DES IN-UTERO EXPOSURE

In the 1940's, diethylstilboestrol (DES) is one of the first hormonal therapeutics which was prescribed to many pregnant women by a lot of g ynecologists. Until 1970, the indications of this therapy was enlarged , before carcinological and reproductives consequences leaded to forbi d obstetrical indications of DES (in France, in 1977 only). In France, 80 000 girls and 80 000 boys are suspected to have been exposed. As f ar as girls are concerned, the studies estimate between 23 % and 36 % the rate of infertility. These studies show also an increased incidenc e of ectopic pregnancy, spontaneous abortions, and premature delivery. The association between various factors of infertility, and typical u terine abnormalities leads to specific therapeutical indications, most ly in assisted procreations. The history of DES points out prescriptio ns of a therapeutic without proofs of its efficiency, the silence of p harmaceutical laboratories which did not take into consideration Dieck man's evaluation, and the difficulties for physicians in affording inf ormation. Nevertheless, the last patients exposed will be 40 years old in 2016 in France. The other hormonal therapeutics which were discove red gave in turn rise hope for enhancing the fertility and providing f rom miscarriage. Over the examples such as Des are not still resolved questions that patients and physicians ask concerning the lack of adve rse effects of a therapy on the foetus, when its clinical efficiency o n the pregnancy is supposed to be proved.