AND SummaryThree hundred and twenty-eight infertile women were selected for treatment with clomiphene citrate because the sole cause of their infertility was absent or infrequent ovulation ; this was induced in 66 -4 per cent with an overall pregnancy rate of 52 per cent. Six types of cytological response to clomiphene are described together with the effect on cervical mucus. Improved results were obtained by a more careful selection of patients and with greater use of combined therapy with human chorionic gonadotrophin, when the ovulatory response rose to 74 per cent with pregnancy rate of 63 per cent.IN 1968 we reported a clinical trial of clomiphene citrate (Clomid, Merrell-National) for the induction of ovulation in unselected women with anovulatory endocrine disorders (Osmond-Clarke, Murray and Bishop, 1968). In this study we found that the biological methods of assessment gave more information about the individual patient's response to clomiphene than any of the biochemical estimations, and theiefore since 1966 we have only used serial endocrine cytology, basal body temperatures and examinations of cervical mucus. We are now reporting the results of treatment of a selected group of women with clomiphene between 1962 and March 1971.

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Summary Three hundred and twenty‐eight infertile women were selected for treatment with clomiphene citrate because the sole cause of their infertility was absent or infrequent ovulation; this was induced in 66.4 per cent with an overall pregnancy rate of 52 per cent. Six types of cytological response to clomiphene are described together with the effect on cervical mucus. Improved results were obtained by a more careful selection of patients and with greater use of combined therapy with human chorionic gonadotrophin, when the ovulatory response rose to 74 per cent with pregnancy rate of 63 per cent.

Outpatient Gynaecology SIR,-We were delighted to read in Mr. Albert Davis's letter (Journal, May 17, p. 1177) that vaginal smears were finding their way into gynaecological outpatients , though we gather as yet their intrusion is only appreciated by the " scientifically minded gynaecologist." Apart from the early diagnosis of uterine cancer, surely they are the simplest and quickest way of assessing ovarian function, and therefore can be useful in the diagnosis and treatment of many gynaecological and endocrine disorders-e.g., primary and secondary amenorrhoea, repeated miscarriages, the menopause, etc. As the majority of patients can be instructed to take their own vaginal smears it is possible to obtain a continued rather than an isolated study of their ovarian activity without admission to hospital, and it therefore seems a pity that this diagnostic aid is not more widely used in this country.-We are, etc.,