HUMAN INFERTILITY 323 



Time will not permit an elaboration of this theme. Suffice to say, that 

 there seems to exist a general endocrinopathic tendency in individual 

 families. This serves only to render the soil more fertile should the later 

 years introduce subversive elements tending to engender incretory dys- 

 function. I am minded of a patient of Dr. J. J. Thomas with whom I have 

 intermittent contact who was born a cretin, but who has received adequate 

 treatment throughout the years. She has borne two healthy normal chil- 

 dren who give no evidence of an inheritance of the serious early maternal 

 endocrinopathy. 



The level of function of each of the several important endocrine glands 

 has a direct bearing on the ultimate fertility of union. Supporting data 

 derive from several sources. Reynolds and Macomber (1) quote a value 

 of about 12 per cent as the normal degree of community infertility, and in 

 arriving at this figure no allowance is made for artificial infertility through 



TABLE 1 



Endocrine influence on fertility 



Normal 



Non-endocrine disorders . 



Pituitary 



Thyroid 



Ovary 



PER CENT INFERTILE 



12* 



20 



29 



31 



35 



* See Reynolds and Macomber (1). 



contraception. The data from a consecutive series of over 1000 cases 

 studied by the speaker are germane to this point. Eliminating patients 

 with less than three years' exposure and those where contraception or 

 induced abortion could affect the outcome, the figures for the relative 

 infertility of the several groups are collected in table 1. 



The group designated as "non-endocrine" was composed of individuals 

 referred for diagnostic study who disclosed functional derangements or 

 organic disease unassociated with the ductless glands. The group con- 

 tained a number of cases of syphilis, of lesions of the central nervous system, 

 and yet other conditions well recognized as depressing fertility. While less 

 fertile than the usual community level, their unions are far more productive 

 than are those with an endocrine factor. 



A second datum on the productivity of mating derives from a series of 

 115 infertile couples carefully studied by the procedures discussed today. 



