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RESEARCH:
Mike Joffe, James Bennett, Nicky Best, and Tina Kold Jensen
Sex ratio and time to pregnancy: analysis of four large European population surveys
BMJ 2007; 0: bmj.39097.508426.BEv1 [Abstract]
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[Read Rapid Response] Sex Ratio
Sameer Chadha, Shikha Mehta, Medical Student , Maulana Azad Medical College, New Delhi ,India   (12 March 2007)
[Read Rapid Response] Secondary sex ratio is not related to fertility in Italian women
Fabio Parazzini, Elena Ricci   (4 April 2007)

Sex Ratio 12 March 2007
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Sameer Chadha,
Medical Student
Maulana Azad Medical College, New Delhi, India,
Shikha Mehta, Medical Student , Maulana Azad Medical College, New Delhi ,India

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Re: Sex Ratio

Sex ratio in India is nearly 927 female to 1000 males.... It is mainly due to the female foeticide being committed in not only rural but also in the urban parts of the country mainly due to the detection of the sex of the fetus by the Ultrasound. Due to increasing reports of female foeticide the Governmenr had to pass the Pre Natal Detection Test Regulation which banned the doctors to reveal the sex of the fetus to the parents and made it punishable by law and now the situation is thus improving. We long to see days where this evil will be rooted out from India and a similar study will be conducted about male ratio and the time to pregnancy.

Competing interests: None declared

Secondary sex ratio is not related to fertility in Italian women 4 April 2007
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Fabio Parazzini,
Researcher
II Clinica Ostetrico Ginecologica, Univ. Milano, via Commenda, 20100 Milano,
Elena Ricci

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Re: Secondary sex ratio is not related to fertility in Italian women

Editor – Joffe et al. (1) tested the hypothesis that a relationship exists between the proportion of male offspring (commonly called the secondary sex ratio) and the time to pregnancy as marker of fertility.

They did not find any association, notwithstanding previous reports that showed male fertility and secondary sex ratio declining in many countries.

We analysed the relationship between difficulties in conception and offspring gender, using data collected on women in the control group of a case-control study (2,3) of risk factors for low birthweight and preterm birth. The present analysis is based on 2002 women (mean age 31 years, range 14-45) who delivered on randomly selected days at the Clinica Luigi Mangiagalli (the largest obstetric hospital in Milan) and the Obstetric and Gynecology Clinic of the University of Verona. During their stay in hospital the women were interviewed by trained interviewers and information was collected about general sociodemographic characteristics and habits, and gynaecological and obstetric history. Difficulty in conception was defined as taking two or more years to conceive or receiving medical treatment for infertility.

Of the 2002 women interviewed, 150 (mean age 32, range 22-43) reported difficulty to conceive. These women were compared with the 1852 women reporting no difficulty. We did not found any relation between difficulty in conception and secondary sex ratio. The 150 women with difficulty to conceive had 72 (52.0%) and 1852 women without difficulty had 999 (53.9%) male babies. In comparison with women without difficulty, the multivariate odds ratio for women reporting a conception delay of delivering a male was 0.91 (95% confidence interval 0.65-1.27). Adjustement was made for maternal age, parity and smoking.

In our study we could not distinguish between paternal and maternal infertility. Despite this limitation, our data agree with the results of Joffe et al. (1) and do not support the hypothesis of association between fertility and secondary sex ratio.

Elena Ricci, PhD Student
Fabio Parazzini, Researcher
II Clinica Ostetrico-Ginecologica, Università di Milano – Fondazione IRCCS “Ospedale Maggiore, Policlinico, Mangiagalli e Regina Elena” via Francesco Sforza, 28 – 20122 Milano

1. Joffe M, Bennet J, Best N, Jensen TK. Sex ratio and time to pregnancy: analysis of four large European population surveys. BMJ 2007; 334: 524-8.

2. Chiaffarino F, Parazzini F, Chatenoud L, Ricci E, Tozzi L, Chiantera V, et al. Coffee drinking and risk of preterm birthEur J Clin Nutr 2006; 60: 610-613.

3. Chiaffarino F, Parazzini F, Chatenoud L, Ricci E, Sandretti F, Cipriani S, et al. Alcohol drinking and risk of small for gestational age Birth. Eur J Clin Nutr 2006; 60: 1062-1066.

Competing interests: None declared