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October 24, 1977

Delayed Fertilization and Down's Syndrome

JAMA. 1977;238(17):1811. doi:10.1001/jama.1977.03280180015006

To the Editor.—  I read with interest the inquiry by Asensi and Prieto, "Can Abnormal Ovulation Be an Etiologic Factor in Down's Syndrome?" (QUESTIONS AND ANSWERS, 237:2330, 1977). A patient of Asensi and Prieto purportedly could recognize the time of ovulation by presence of a "tingling sensation" on the side from which the oocyte was released. Five days after presumptive ovulation from the right ovary, the patient renewed sexual activity after a prior period of abstinence; on the same day "tingling" also occurred on the left side. The patient gave birth to a child with a Down's syndrome karotype 244 days later. The authors wondered whether "a 21-day prematurely released ovum" could be etiologically related to "the defective child." The respondent did not directly answer the query, in my opinion, and thus the following comments may prove informative.In addition to the unproved but often implicated causes for nondisjunction noted