- Email: [email protected]
THE ANTI-ABORTION LOBBY
1423 THE PRICE OF LIBERTY
SiR,—Icannot let Dr Barnaby’s article on Military Expenversus Social Welfare (June 7, p. 1225) and your accom-
diture
panying editorial pass without comment. It is obvious that there is a lack of natural resources in the world and that money for military expenditure would be better used in other ways. It should also be obvious, however, where the blame for this increasing military expenditure lies, especially when the question concerns the western democracies, and this should be stated unequivocally. Since the rape of Poland with Hitler in 1939 through subsequent annexation of most of Eastern Europe and the present violation of Afghan-
istan the Soviet Union has made plain both its internal and external policies. Barnaby is quite right in saying that a major threat to our way of life will be economic difficulties both in Europe and in the Third World but he should direct his energies at persuading Soviet Russia to respect human rights and to renounce its imperialistic policy. Until this happens there is
strong defence policy for Europe if we wish to preserve our democratic rights. no
alternative
same taxation and private pension advantages as "private practice" (i.e., the treatment of private patients) and exactly the same problems-that for some specialties and in some areas little or no such work is available, whilst in others substantial amounts can be done, earning for some a greater nett income than the private practice of the average part-time consultant. The Review Body’s 10th report (para 15) cannot in all fairness consider the "private practice earnings" of whole-time consultants without considering their earnings from category 11 work; and therefore the recent contract changes do not pose any new threat to the whole-time consultant’s N.H.S. salary.
North Ormesby Hospital,
Middlesbrough,
Hospital, Davyhulme, Manchester M31
3SL
T. KONDRATOWICZ
your editorial on the continued expansion of military spending, with diversion of scarce resources from the social welfare of both the developed and the developing world, you suggest that disarmament has never attracted mass support because the issues are so large and intimidating. We agree, and would add that the consequences of the use of the world’s arsenals are never adequately debated, in part because
SIR,-In
they are too terrible to contemplate. Informed public debate on the potential effects of nuclear war must continue, with contributions from scientists, doctors, and government. To this end the Medical Association for the Prevention of War is arranging a conference in London on Nov. 1, 1980, entitled The Medical Consequences of Nuclear Disaster. Medical Association for the Prevention of War, 77 Theberton Street, London N1
DUNCAN LEYS MARGARET PENROSE HUMPHREY HODGSON SHIRLEY HODGSON
THE ANTI-ABORTION LOBBY
SIR,-In stating that anti-abortion forces are "religious pressure groups" (June 7, p. 1253) Mrs Simms aligns herself with a founder father of the pro-abortion movement in the United States, Dr B. Nathanson. However, in his book Aborting America he admits that the religious label was a deliberate deceitful ploy used to gain support for abortion. The D.H.S.S. "cat-and mouse licence" to Pregnancy Advisory Service is merely a face-saving appeasement gesture intended for Parliament and the public. British Section, World Federation of Doctors Who Respect Human Life, 75 St Mary’s Road, Huyton, Merseyside L36 5SR
ROGER HOLE
3HJ
FEMALE FERTILITY AND DONOR INSEMINATION
to a
Park
Cleveland TS3
SIR,-Retrospective studies have shown that pregnancy occur in the presence of severely abnormal semen;’ on the
may
whose sperm characteristics fall within the to be subfertile enough for the couple to be candidates for donor artificial insemination (AID). Such spontaneous (i.e., non-AID) pregnancies may be explained by prolonged exposure to hypofertile semen and/or by very high female fertility. Thus couples where the woman is very fertile should disappear from the population of childless couples who turn to AID because of severe male subfertility. This cannot happen when the husband is azoospermic, so the pregnancy rate through AID would be expected to be higher in couples with azoospermia than in couples with severe male subfertility. This point seems to have been overlooked in published reports on AID, so we turned to our own series to check the validity of this hypothesis. Over the past four years, 139 couples have been taken on in an AID programme with donor sperm frozen in 0.25 ml volumes in a straw. Pregnancy rates were significantly higher, both overall and per insemination cycle, for the women whose husbands were azoospermic (p<0.01) (see table). All the clinical management, fertility investigations, and treatment were undertaken by the same gynxcologist; all the inseminations were done by the same team of three physicians; and the biological evaluations were done by the same technicians and the laparoscopic examination by the same surgeon. The two series may thus be considered as homogeneous in these respects. The random distribution of donors between both groups has also been checked.
other hand, same
range
men
usually considered
are
1. MacLeod J, Wang Y. Male fertility potential in terms of semen quality: a review of the past, a study of the present. Fertil Steril 1979; 31: 103. 2. Emperaire JC, Audebert A. Evaluation of female fertility. In: Husband artificial insemination Emperaire JC, Audebert A, Hafez ESE, eds. The Hague: Martinus Nijhofl, 1980: 8. AID RESULTS IN REVIEW OF
HUSBAND’S
139
COUPLES ACCORDING TO
SPERM CHARACTERISTICS
PEGGY NORRIS, Hon. Secretary
CONSULTANT CONTRACTS
SiR,-The N.H.S. Consultants’ Association (June 14, p.
1305) and the Review Body
both seem to have overlooked the fact that whole-time consultants have always been able to earn fees without restriction from category 11 work (e.g., medicolegal and life insurance reports). This work has exactly the
I *
Sperm
count
<5
I
I
million/ml and/or initial motility <20c,f
forms <30%.. t See Emperaire and Audebert.2
and/or oval
SiR,—Icannot let Dr Barnaby’s article on Military Expenversus Social Welfare (June 7, p. 1225) and your accom-
diture
panying editorial pass without comment. It is obvious that there is a lack of natural resources in the world and that money for military expenditure would be better used in other ways. It should also be obvious, however, where the blame for this increasing military expenditure lies, especially when the question concerns the western democracies, and this should be stated unequivocally. Since the rape of Poland with Hitler in 1939 through subsequent annexation of most of Eastern Europe and the present violation of Afghan-
istan the Soviet Union has made plain both its internal and external policies. Barnaby is quite right in saying that a major threat to our way of life will be economic difficulties both in Europe and in the Third World but he should direct his energies at persuading Soviet Russia to respect human rights and to renounce its imperialistic policy. Until this happens there is
strong defence policy for Europe if we wish to preserve our democratic rights. no
alternative
same taxation and private pension advantages as "private practice" (i.e., the treatment of private patients) and exactly the same problems-that for some specialties and in some areas little or no such work is available, whilst in others substantial amounts can be done, earning for some a greater nett income than the private practice of the average part-time consultant. The Review Body’s 10th report (para 15) cannot in all fairness consider the "private practice earnings" of whole-time consultants without considering their earnings from category 11 work; and therefore the recent contract changes do not pose any new threat to the whole-time consultant’s N.H.S. salary.
North Ormesby Hospital,
Middlesbrough,
Hospital, Davyhulme, Manchester M31
3SL
T. KONDRATOWICZ
your editorial on the continued expansion of military spending, with diversion of scarce resources from the social welfare of both the developed and the developing world, you suggest that disarmament has never attracted mass support because the issues are so large and intimidating. We agree, and would add that the consequences of the use of the world’s arsenals are never adequately debated, in part because
SIR,-In
they are too terrible to contemplate. Informed public debate on the potential effects of nuclear war must continue, with contributions from scientists, doctors, and government. To this end the Medical Association for the Prevention of War is arranging a conference in London on Nov. 1, 1980, entitled The Medical Consequences of Nuclear Disaster. Medical Association for the Prevention of War, 77 Theberton Street, London N1
DUNCAN LEYS MARGARET PENROSE HUMPHREY HODGSON SHIRLEY HODGSON
THE ANTI-ABORTION LOBBY
SIR,-In stating that anti-abortion forces are "religious pressure groups" (June 7, p. 1253) Mrs Simms aligns herself with a founder father of the pro-abortion movement in the United States, Dr B. Nathanson. However, in his book Aborting America he admits that the religious label was a deliberate deceitful ploy used to gain support for abortion. The D.H.S.S. "cat-and mouse licence" to Pregnancy Advisory Service is merely a face-saving appeasement gesture intended for Parliament and the public. British Section, World Federation of Doctors Who Respect Human Life, 75 St Mary’s Road, Huyton, Merseyside L36 5SR
ROGER HOLE
3HJ
FEMALE FERTILITY AND DONOR INSEMINATION
to a
Park
Cleveland TS3
SIR,-Retrospective studies have shown that pregnancy occur in the presence of severely abnormal semen;’ on the
may
whose sperm characteristics fall within the to be subfertile enough for the couple to be candidates for donor artificial insemination (AID). Such spontaneous (i.e., non-AID) pregnancies may be explained by prolonged exposure to hypofertile semen and/or by very high female fertility. Thus couples where the woman is very fertile should disappear from the population of childless couples who turn to AID because of severe male subfertility. This cannot happen when the husband is azoospermic, so the pregnancy rate through AID would be expected to be higher in couples with azoospermia than in couples with severe male subfertility. This point seems to have been overlooked in published reports on AID, so we turned to our own series to check the validity of this hypothesis. Over the past four years, 139 couples have been taken on in an AID programme with donor sperm frozen in 0.25 ml volumes in a straw. Pregnancy rates were significantly higher, both overall and per insemination cycle, for the women whose husbands were azoospermic (p<0.01) (see table). All the clinical management, fertility investigations, and treatment were undertaken by the same gynxcologist; all the inseminations were done by the same team of three physicians; and the biological evaluations were done by the same technicians and the laparoscopic examination by the same surgeon. The two series may thus be considered as homogeneous in these respects. The random distribution of donors between both groups has also been checked.
other hand, same
range
men
usually considered
are
1. MacLeod J, Wang Y. Male fertility potential in terms of semen quality: a review of the past, a study of the present. Fertil Steril 1979; 31: 103. 2. Emperaire JC, Audebert A. Evaluation of female fertility. In: Husband artificial insemination Emperaire JC, Audebert A, Hafez ESE, eds. The Hague: Martinus Nijhofl, 1980: 8. AID RESULTS IN REVIEW OF
HUSBAND’S
139
COUPLES ACCORDING TO
SPERM CHARACTERISTICS
PEGGY NORRIS, Hon. Secretary
CONSULTANT CONTRACTS
SiR,-The N.H.S. Consultants’ Association (June 14, p.
1305) and the Review Body
both seem to have overlooked the fact that whole-time consultants have always been able to earn fees without restriction from category 11 work (e.g., medicolegal and life insurance reports). This work has exactly the
I *
Sperm
count
<5
I
I
million/ml and/or initial motility <20c,f
forms <30%.. t See Emperaire and Audebert.2
and/or oval