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March 24, 1969, Vol 207, No. 12 >
ARTICLE | March 24, 1969

Effect of Sex Hormones on Fetal Hemoglobin Levels

Ernest Beutler, MD
JAMA. 1969;207(12):2284-2285. doi:10.1001/jama.1969.03150250114027.
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To the Editor:—  I have read with considerable interest the letter by Sutnick et al (206:1795, 1968) suggesting that additional observations on the effect of sex hormones on fetal hemoglobin levels would be of value. Some years ago we reported such studies.1 Two patients with sickle cell disease were given chorionic gonadotropin and one was given conjugated equine estrogens and progesterone. Like Sutnick et al we observed transient increases in levels of hemoglobin F in both patients who were given chorionic gonadotropin.Subsequently, we have also carried out estimations of fetal hemoglobin levels in patients with malignant disorders receiving methotrexate, because it was known that some patients with megaloblastic anemias have increased levels of fetal hemoglobin in the circulation. No consistent effect on fetal hemoglobin levels could be achieved in these studies.We agree that preventing or reversing the switch from γ-chain production to β-chain production is an intriguing

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