DeCherney A H, Cholst I, Naftolin F
Fertil Steril. 1981 Dec;36(6):741-5. doi: 10.1016/s0015-0282(16)45919-4.
The association between the use of diethylstilbestrol (DES) and vaginal and cervical adenocarcinoma and adenosis in the progeny was first reported by Herbst et al. in 1971. This progeny will reach a peak as far as reproduction is concerned in this decade. It is estimated that 2 million women may be involved to varying degrees. Changes in uterine and cervical contour and structure have been detailed. Thus DES exposure and anatomic changes in the Müllerian system have been documented. In this report 16 women in the reproductive age group who were exposed to DES in utero and presented with infertility are discussed. On workup for infertility they were found to have unique tubal morphologic features consisting of a foreshortened, convoluted tube with "withered" fimbria with a pinpoint os at laparoscopy. The diagnosis could not be made at the time of hysterosalpingogram. Three patients had surgery in an attempt to correct this condition; and in all cases the surgery was unsuccessful. No statistical data is offered as to epidemiologic factors or incidence rates, but the suspected increase in infertility and ectopic pregnancy rates in patients with DES exposure may corroborate these findings.
己烯雌酚（DES）的使用与其后代发生阴道和宫颈腺癌及腺病之间的关联最早由赫布斯特等人于1971年报道。就生育而言，这一代DES后代将在本十年达到高峰。据估计，可能有200万女性会受到不同程度的影响。子宫和宫颈轮廓及结构的变化已有详细描述。因此，DES暴露与苗勒系统的解剖学变化都有记录。本报告讨论了16名在子宫内接触过DES且患有不孕症的育龄妇女。在对不孕症进行检查时，发现她们具有独特的输卵管形态特征，即在腹腔镜检查时可见输卵管缩短、盘绕，伞端“枯萎”，输卵管开口极小。子宫输卵管造影时无法做出诊断。3名患者接受了手术以试图纠正这种情况；但所有病例手术均未成功。文中未提供关于流行病学因素或发病率的统计数据，但DES暴露患者中不孕症和异位妊娠率疑似增加这一点可能证实了这些发现。
