Chromosomal abnormalities in the Kaiser-Permanente Birth Defects Study, with special reference to contraceptive use around the time of conception

Chromosomal abnormalities were studied in 33,551 abortions and births to women whose contraceptive histories had been recorded at their first antenatal visit in 1975-1977. Chromosome examinations were performed exclusively on clinical grounds. There were 45 de novo abnormalities detected (1.34/1,000); three of them were detected at amniocentesis. Trisomy 21 was observed in 27 cases (0.80/1,000), trisomy 18 in nine (0.27), other trisomies in three (0.09), and translocations or deletions in five (0.15). One case of triploidy and six cases of inherited abnormalities were detected. There were no significant racial variations. No increase in risk for chromosomal abnormalities was found among women who had used oral contraceptives prior to becoming pregnant or among women who experienced oral contraceptive breakthrough pregnancies. Two cases of trisomy 18 were observed among the 814 deliveries following oral contraceptive breakthrough conceptions (2.46/1,000), two cases of trisomy 21 occurred in 338 births following failures of rhythm contraception (5.92/1,000), and no cases of trisomy 21 or 18 among the 1,569 women using spermicides at the time of conception.

[Use of technique of culturing cells in diffusion chamber in host-mediate for testing chromosomal effects of gossypol acetate on human lymphocytes]

Human peripheral blood lymphocytes were cultured in diffusion chamber in mice after short-term administration of gossypol acetate. The induced chromosomal aberrations of human target cells indiffusion chamber were used as indices of DNA damage. The results showed that the mean frequency of chromosomal aberration of the human lymphocytes in Gossypol-treated mice was slightly higher than that in the control group, but the difference between them was not statistically significant (p 0.05).

Further investigations on the cytological effects of some contraceptives

Anovlar induces a mitodepressive effect, producing abnormal prophases and a considerable number of micronuclei, i.e. Anovlar can produce major cytological abnormalities. On the other hand, Lyndiol induces minor abnormalities leaving the process of mitosis to proceed almost normally. Microgynon 30 did not show any effect on any of the mitotic stages. Our conclusion may offer an explanation for the contradictory results found in the literature upon the cytological effect of oral contraceptives, although the major chemical constitution of all contraceptives used is the same, still there are minor differences in their chemical structure. These minor differences in chemical structure may be the deciding cause whether or not a contraceptive is harmful.

Chromosomally competent ovarian failure at adolescence

Three female adolescents are presented with delayed or incomplete secondary sexual development due to primary ovarian failure. All three patients had normal blood leukocyte and ovarian tissue karyotypes. The importance of performing a diagnostic laparoscopy with ovarian biopsy in the setting of chromosome competent ovarian failure (CCOF) is emphasized.

Study of nucleolar organizer in women with galactorrhea, or polycystic ovaries, or using oral contraceptive

In this paper we report on changes of the Ag-stained NOR (Ag-NOR) and Ag-stained acrocentric association (Ag-AA) frequencies in lymphocytes of women with polycystic ovaries, galactorrhea, or taking oral contraceptives. The results showed that Ag-AA frequencies were increased significantly in all three study groups while the Ag-NOR frequencies apparently did not increase. We assume that a difference in average Ag-NOR frequency between the two groups may be a measure of the change in the number of active rRNA genes, and that differences of Ag-AA frequency among populations reflect the change in transcriptional rate of the active rRNA genes.

Fetal anatomical abnormalities and other associated factors in middle-trimester abortion and their relevance to patient counselling

Fetuses present in 91 consecutive spontaneous or missed middle-trimester abortions were studied anatomically and tissue karyotyping was attempted. Anatomical abnormalities were found in 32 fetuses, two of these also had chromosomal abnormalities, six of these abortions were associated with other possible aetiological factors. In a further 23 pregnancies there were probably significant aetiological factors associated with the abortion and in 10, where the fetus had arrested growth, there were two with other possible factors. From a prospective analysis of subsequent pregnancies it would appear that if all the factors relating to middle-trimester abortion, including fetal autopsy, are analysed, better patient counselling and realistic prognoses can be given for subsequent pregnancy.

Lack of correlation between contraceptive pills and Down's syndrome

A case-control study has been made on the use of oral contraceptives before pregnancy and the birth of an infant with Down's syndrome. Controls were matched for age and parity and selected from the Medical Birth Register. Information on Pill usage was obtained from the Swedish standardized maternity health record which contains dates for when the women stopped using the Pill and for last menstrual period. There was no indication of any relation between the use of oral contraceptives and Down's syndrome.

Toxicity of a male contraceptive, gossypol, in mammalian cell cultures

Gossypol, a substance extracted from cotton plants, is a potential male contraceptive. Although human users reported only mild or no side effects, our study found gossypol to be cytotoxic to cultured mammalian cells. A dose dependent decrease in the number of viable cells and mitotic index was demonstrated with both Chinese hamster ovary (CHO) cells and human lymphocytes after the cultures received treatment of gossypol for various durations. Cellular DNA, RNA, and protein synthetic activities were reduced in the presence of gossypol. However, gossypol did not seem to induce chromosome breakage or polyploidy.

A comparative cytogenetic study on cases of induced abortions in TCDD-exposed and nonexposed women

In order to evaluate the cytogenetic findings previously obtained on induced abortions in women exposed to 2,3,7,8 tetrachlorodibenzo-p-Dioxim (TCDD) after the Seveso accident, chromosome analyses were carried out on a comparable control sample. The frequencies of aberrant cells, the relative proportions of individual types of chromosome aberration, the average number of lesions per damaged cell, and the frequencies of polyploids do not differ significantly in maternal blood and placenta in the two samples. A highly significant increase in the frequencies of aberrant cells and in the average number of aberrations per damaged cell was found in the fetal tissues in the group of exposed pregnancies. A noticeable feature of the data on the frequencies of cells with aberrations is the marked variability among individuals within tissues and within samples. On the basis of these results, the authors point to the need to continue cytogenetic investigations on interrupted pregnancies in TCDD-exposed and nonexposed women.

Vaginal spermicides, chromosomal abnormalities and limb reduction defects

Each year, 300,000-600,000 U.S. women become pregnant while using vaginal spermicides. Two recent reports hypothesized that offspring from these pregnancies are at increased risk of certain birth defects, particularly limb reduction defects and such chromosomal abnormalities as Down syndrome. In a case-control analysis of data from the Metropolitan Atlanta Congenital Defects Program (MACDP), we studied the teratogenicity of spermicides by comparing their use around the time of conception by mothers of infants with chromosomal abnormalities and limb reduction defects to their use by mothers of infants with birth defects that have not been linked to spermicides. The results do not support the hypothesis that spermicides are teratogenic. For infants whose mothers used spermicides at the time of conception, the relative risk of having Down syndrome was 1.2 and that for other chromosomal abnormalities was also 1.2. The relative risk of limb reduction defects among infants exposed to spermicides in the first trimester was 1.0. None of these risks is statistically significant.

Fertility after discontinuation of oral contraceptives

Concern has been expressed regarding fertility following oral contraceptive (Pill) use. A review of the literature indicates that there is a slight delay in the return of fertility in Pill users but no permanent impairment results. A small proportion of women experience a prolonged period of amenorrhoea following cessation of combined oral contraception, but whether the Pill plays an aetiological role is doubtful since there appear to be no differences in endocrine profiles amongst women with amenorrhoea following Pill use and those with secondary amenorrhoea who have never used oral contraceptives. Factors which may predispose to amenorrhoea following Pill use are: late onset of menarche, previous oligomenorrhoea and low body weight. Following adequate investigation and treatment, fertility rates in women with the so-called post-Pill amenorrhoea syndrome return to normal. There is no evidence of any delay in the return of fertility in women who use the progestogen-only Pill.

The chromosomal effects of the oral contraceptive

A general review of reports on the chromosomal effects of oral contraceptive has been undertaken, and it is quite apparent that there is a scarcity of literature on these very important investigations. Also, those that have been undertaken, cannot be properly assessed on account of, one supposes, subjects' background and lack of numbers, differences in techniques and, above all, the small number of metaphases analyzed. Apart from the report by Mills and colleagues [16], none of the reports mentioned exogenous agents to which the subjects might have been exposed, especially in cases where there has been an increased frequency of chromosomal aberrations. All these considerations must be taken into account for, as yet, the reports are too conflicting to 'indict' the oral contraceptive as having chromosome-breaking properties.

Endometrial carcinoma in young women

Endometrial carcinoma in young women is uncommon. The majority of cases occur in women who have been taking oestrogen-containing oral contraceptives, in those with the Stein-Leventhal syndrome, or in those with gonadal dysgenesis treated by long-term oestrogen replacement therapy. We have observed 4 women under 40 years of age with adenocarcinoma of the uterus in whom chromosomal abnormalities associated with Turner's syndrome were confirmed only after the diagnosis of carcinoma had been made. None of these had received replacement oestrogen therapy. It is postulated that chromosomal abnormalities in young women with endometrial carcinoma are more common than previously thought. As the disease in this group appears to behave in a benign fashion, a conservative approach to therapy is advocated.

Epidemiologic detection of low dose effects on the developing fetus

Evaluations of the health effects of exposures in the workplace and environment have broadened to include effects on reproduction, as well as on the development of cancer. Models to assess risks associated with varying doses of exposure rest almost entirely on data about cancer. In this paper we discuss some distinctive features of reproduction which bear on the interpretation of such models, when applied to reproduction, rather than carcinogenesis. Dose-response curves describe the relationship between two exposures (smoking and alcohol drinking) and two outcomes (spontaneous abortion and birthweight) are used to illustrate some of the questions which arise in attempting to determine a "safe" level of exposure.

Chromosomal variants and male fertility

One hundred and forty-seven healthy men were investigated to determine whether there was an association between chromosomal variants and decreased fertility. Modern chromosome banding techniques detected normal variant karyotypes in 22 (15%) of these men. The fertility parameters of the 125 men with 46,XY karyotype were compared with those of the 22 men in the variant group. Analysis of the results showed that the two groups were not biologically different with respect to semen analysis and reproductive hormone levels.

Diethylstilbestrol-exposed monozygotic twins discordant for cervicovaginal clear cell adenocarcinoma

Monozygotic, 17-year-old, female twins exposed to diethylstilbestrol (DES) in utero and discordant for cervicovaginal clear cell adenocarcinoma are reported. Benign teratologic changes were present in both. The twin with cancer was treated by extensive operation and postoperative irradiation. No tumor has appeared in either twin in the 4 years subsequent to therapy. Discordance for cervicovaginal clear cell adenocarcinoma in this situation suggests that factors other than embryonic exposure to DES, extrauterine in location and nongenetic in character, were operative in tumorigenesis. The twins were compared in regard to lifetime radiation exposure and evidence of previous viral disease. The only substantial difference was an elevated titer of antibody in the twin with cancer to the capsid antigen of the Epstein-Barr virus, a herpesvirus with oncogenic capability.

[Peculiarities of pregnancies in women in the fifth decade of life (author's transl)]

From 1974-1978, 101 women in the fifth decade of life were delivered. The course of the pregnancy was more often complicated by pre-eclampsia. Premature and dysmature deliveries were not more common than in younger women. The sex ratio was more in favor of females than usual. Despite shorter duration of labor and delivery the Apgar ratings at 1 and 5 minutes were less favorable in the new borns of older pregnant women. The infants required more often intubation and transfer to the pediatric hospital. The perinatal mortality was 4.2%. Down syndrome occured in 4.2% of the infants and abnormalities occured in 4.9%. Routine genetic amniocentesis and intensive pregnantal care should lower the fetal morbidity and mortality in these cases. Urinary total estrogen determinations are proposed as a parameter for the monitoring of the these risk cases besided ultra-sound and fetal monitoring.