Summary
A new anti‐oestrogen, tamoxifen, has been synthesized and is available for clinical trials. Its value in the treatment of anovulatory infertility has been assessed in 32 patients. A total of 26 patients apparently ovulated, 16 patients conceived during a treatment cycle, and 2 patients became pregnant during the first spontaneous cycle thereafter. There was no increase in the abortion rate and there were no multiple pregnancies. Side‐effects were uncommon and none were serious.
Meiotic and histological studies have been carried out on testicular biopsies from an azoospermic human male who exhibited normal secondary sex characteristics. A failure in the formation of chiasmata during the first meiotic prophase resulted in a breakdown of the subsequent meiotic and spermatogenic processes. The few spermatozoa formed exhibited a range of DNA contents consistent with a random orientation and movement of the meiotic chromosomes. Radiation studies carried out on peripheral lymphocytes demonstrated that the patient had a reduced facility for chromosomal DNA repair. It is suggested that this defect gives an explanation for the failure of chiasma formation since chiasma formation probably involves a breakage, crossingover and repair of chromosomal DNA during the first meiotic prophase.
Trends in multiple birth rates are thought to have been substantially affected by subfertility treatments in the last 25 years, but there are few quantitative assessments of this. This paper examines trends in twin and higher multiple birth rates separately in Scotland, England and Wales and compares their course with corresponding multiple birth rates in the Oxford Record Linkage Study area, where the proportions following subfertility treatment are documented. National data on prescriptions for subfertility treatments reinforce the view that they have had a major effect on the trends, and currently perhaps 60% of triplet and higher order births and 15% of twins follow their use in Britain.
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