Phenotypic differences in upper genital tract abnormalities and reproductive history in dizygotic twins exposed to diethylstilbestrol in utero. A case report.

Major phenotypic variations in reproductive function and upper genital tract abnormalities were found between 30-year-old dizygotic twins exposed in utero to diethylstilbestrol (DES). The women were exposed to maternal DES doses of 12.5-50.0 mg daily starting from the 12th gestational week as documented in the original antepartum obstetric office records. Twin A had primary involuntary infertility of over four years' duration associated with a severe DES uterine deformity on hysterosalpingography (HSG). A complete evaluation demonstrated all other infertility investigations to be normal. Twin B had two term pregnancies but a significant history of reproductive loss, including three miscarriages and one ectopic pregnancy. HSG demonstrated mild DES-induced changes. Cervical adenosis was observed only in the more severely affected twin.