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American Journal of Epidemiology Advance Access published online on June 27, 2007
American Journal of Epidemiology, doi:10.1093/aje/kwm136
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American Journal of Epidemiology Copyright © 2007 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

Original Contribution

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

Lauren A. Wise1, Linda Titus-Ernstoff2,3, Julie R. Palmer1, Robert N. Hoover4, Elizabeth E. Hatch5, Kimberly M. Perez6, William C. Strohsnitter7, Raymond Kaufman8, Diane Anderson9 and Rebecca Troisi2,4

1 Slone Epidemiology Center, Boston University, Boston, MA
2 Departments of Community and Family Medicine and of Pediatrics, Dartmouth Medical School, Lebanon, NH
3 The Hood Center for Children and Families, Dartmouth-Hitchcock Medical Center, Lebanon, NH
4 Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
5 Department of Epidemiology, Boston University School of Public Health, Boston, MA
6 Department of International Health, Boston University School of Public Health, Boston, MA
7 Department of Obstetrics and Gynecology, New England Medical Center, Boston, MA
8 Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX
9 Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL

Correspondence to Dr. Lauren A. Wise, Slone Epidemiology Center, Boston University School of Public Health, 1010 Commonwealth Avenue, Fourth Floor, Boston, MA 02215 (e-mail: lwise{at}bu.edu).

Received for publication November 8, 2006. Accepted for publication March 27, 2007.

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 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 = 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


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