Seventeen men who were exposed in utero to diethylstilbestrol (DES), 12 non-DES-exposed volunteers, and 11 fertile control subjects were evaluated by physical examination, seminal fluid analysis, and sperm penetration assay (SPA). Fourteen of the 17 male subjects exposed to DES in utero and two of the 12 non-DES-exposed volunteers had SPAs of less than 14% and qualified as infertile by the criteria of this test. All 11 fertile control subjects had demonstrated SPA values in the fertile range. Thirteen of the 17 DES-exposed male subjects, four of the 12 non-DES-exposed volunteers, and four of the 11 fertile control subjects demonstrated at least one abnormality of the reproductive organs.
PIP: The association of in utero exposure to DES (diethylstilbestrol) and subsequent occurrence of clear cell carcinoma of the vagina and of lesion of the female reproductive tract is well known. Recent data have suggested that in utero DES exposure may also be harmful to male fetuses. This article presents the results of a study carried out on 17 male subjects exposed prenatally to DES, on 12 volunteers not exposed to DES, and on 11 husbands of pregnant women. All subjects were evaluated by physical examination, SFA (seminal fluid analysis), and SPA (sperm penetration assay). 14 out of 17 DES-exposed subjects and 2 out of 12 nonexposed volunteers has SPAs of less than 14%, which qualifies as infertile, while all 11 fertile control subjects had SPA values in the fertile range. 13 of the 17 DES-exposed subjects, 4 of the 12 nonexposed subjects, and 4 of the 11 control subjects had at least one abnormality of the reproductive organs, particularly varicocele and epididymal cysts. If one accepts SPA as a valid predictor of fertility than it seems possible that DES exposure may create a major fertility hazard for men.