Compliance at colposcopy clinics is an essential factor for effectiveness of a cervical screening programme. However, there is not enough research on women who default from the colposcopy clinic. In this study, we have looked at some of the factors which might influence non-attendance at colposcopy clinics. We found that women who were younger and nulliparous appeared to be at greater risk of non-attendance than older and parous women. Women tend to miss follow-up appointments rather than primary appoints and none of them missed treatment appointments. There was no relation between non-attendance and grade of the lesion. We were not able to assess other factors such as smoking, socio-economic status or marital status in this study due to inadequate documentation.

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A 17 year old girl was referred with a history of oligomenorrhoea. She had attained the menarche at the age of 11 years and had always had irregular periods. Over the previous 16 months, she had only two periods that were light and lasted ®ve days each.She was sexually active, used a barrier method of contraception and was nulliparous. There was no signi®-cant medical or family history. She was in good physical and mental health and was of average height and weight with a body mass index of 22. She had normal secondary sexual characteristics.An ultrasound scan of the pelvis showed a normal uterus and ovaries with a right ovarian follicle measuring 2.8 cm. Her plasma prolactin was 184mU/ L, follicle stimulating hormone was 83 iu/L, luteinising hormone was 42.2 iu/L and oestradiol was ,80 pmol/L. These levels were similar to those measured nine months earlier. Cytogenetic analysis of peripheral blood revealed an abnormal X chromosome with the following karyotype:46, X, der (X) t (X;5) (q27;p14). ish der (X) t (X;5) (wcpX1, wcp51, 210 B51, 878a7-, D5S231) ( Fig.1) Fluorescence in-situ hybridisation was carried out on a repeat blood sample to determine the nature of this abnormal X chromosome. A whole chromosome X paint hybridised to all of the normal X chromosome, to all of the short arm and approximately 75% of the long arm of the abnormal X chromosome. Use of the whole chromosome 5 paint showed that the additional material on the abnormal X was from chromosome 5. Thus the studies concluded that the abnormal X was a derived X chromosome resulting from an unbalanced translocation between an X chromosome long arm and a chromosome 5 short arm. (Fig. 2) Three months later her plasma hormone levels were: follicle stimulating hormone 30.6 iu/L; luteinising hormone 43.3 iu/L and oestradiol 189 pmol/L. This was shortly followed by a menstrual period lasting ®ve days with a moderate blood loss.A diagnosis of premature ovarian failure with an unbalanced X chromosome, with autosome translocation of the long arm of the X chromosome was made. The young woman was advised to take hormone replacement therapy. DiscussionThe criteria for diagnosis of premature ovarian failure are more than four months of amenorrhoea, with two serum follicle stimulating hormone values of .40 iu/L taken four months apart in a women less than 40 years of age. The incidence is 1 % at 40 years and 0.1 % at 30 years and decreases as age decreases 1 . The varying degrees of premature ovarian failure have been referred to as a spectrum of ovarian dysfunction ranging from ovarian dysgenesis to premature menopause 2 . Factors affecting apoptosis or programmed cell death through various phases of ovarian function from birth through to the menopause are not clearly understood, making it dif®cult to de®ne the aetiology of the vast majority of these cases. In a recent review of 323 women with premature ovarian failure the causes were 2 : Idiopathic 59%; Turner's syndrome 23%; Iatrogenic 10%; familial premature ovarian failure 4%; galactosaemia 2%; 46 XY gonadal ...

A retrospective audit to compare the performance of a colposcopy clinic with the standards set by National Health Service Cervical Screening Programme (NHSCSP) was carried out at Caerphilly District Miners Hospital, South Wales, United Kingdom. The study sample size consisted of 150 women who underwent colposcopy and diathermy large loop excision of the transformation zone (LLETZ) for abnormal cytology during January l995 to January 1998. The results showed deficiencies in the areas of communication for clinic appointments for women with high‐grade cytology and in information given to general practitioners about test results. The services fell short of the standards in recording of colposcopy findings and grading of lesions. The rest of the parameters audited reached the NHSCSP standards. Recommendations to improve communication and to increase the objectivity of recording colpscopy findings were made. A more practical approach to set standards in areas of communication was suggested.