Infertility among women exposed prenatally to diethylstilbestrol

Although it is well established that women exposed to diethylstilbestrol in utero have an increased risk of spontaneous abortion, ectopic pregnancy, a nd preterm delivery, it is not known whether they also have an increased ri sk of infertility. The authors assessed this question in data from a collab orative follow-up study of the offspring of women who took diethylstilbestr ol during pregnancy. In 1994, 1,753 diethylstilbestrol-exposed and 1,050 un exposed women from an ongoing cohort study (National Cooperative Diethylsti lbestrol Adenosis Study and Dieckmann cohorts) provided data on difficultie s in conceiving and reasons for the difficulty. Age-adjusted relative risks were computed for the association of diethylstilbestrol exposure with spec ific types of infertility. A greater proportion of exposed than unexposed w omen were nulligravid (relative risk (RR) = 1.3, 95% confidence interval (C I): 1.1, 1.5), and a greater proportion had tried to become pregnant for at least 12 months without success (RR = 1.8, 95% CI: 1.6, 2.1). Diethylstilb estrol exposure was significantly associated with infertility due to uterin e and tubal problems, with relative risks of 7.7 (95% CI: 2.3, 25) and 2.4 (95% CI: 1.2, 4.6), respectively. The present findings indicate that diethy lstilbestrol-exposed women have a higher risk of infertility than do unexpo sed women and that the increased risk of infertility is primarily due to ut erine or tubal problems.