Vaginal Spermicides and Congenital Disorders: The Validity of a Study-Reply

In Reply.—  The article written by Drs Jick, Walker, Rothman, Watkins, and me (and several other individuals) has been the subject of a considerable amount of debate since its publication. Unfortunately, the article is often cited as showing a positive association between conception while using a spermicidal jelly and the occurrence of birth defects. Those citing the article in this way do not note the reservations expressed in the article about the findings, including the lack of information as to the mechanism by which nonoxynol 9 would reach the developing embryo, "the absence of a single, well-defined syndrome among the infants," the lack of information about the precise time of exposures, and the possibility of other confounding factors. The last sentence in the article notes our concerns about unanswered questions and the tentative nature of the findings.No articles published subsequently have shown unequivocal evidence that spermicides are teratogenic. In