***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
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    Input: In a prospect i ve study 265 patients with threatened abortions were divided into 2 groups . One group of 134 patients received treatment with Oestradiol benzoat and hydroxyprogesterone capronat . The other group of 131 patients received no hormonal treatment . Of the group treated with hormones 40.7 % of the women had an abortion . Of the group treated with placebos 39.7 % of the patients had an abortion . There was therefore no difference in the success rate of the treatment of threatened abortion irrespective of the administration of hormones or placebos . The value of hormonal therapy in the treatment of threatened abortion is therefore question able This follow-up study presents the effects of DES on the genital tract of male and female offspring of mothers who were part of a double-blind , placebo-controlled investigation during 1951 and 1952 aim ed at determining the effect of DES on pregnancy . Epididymal cysts , hypotrophic testes , and capsular in duration were the more common genital lesions found in 25 % of 163 DES-exposed males as compared to 6 % in 168 control males .  Semen analysis data on 39 subjects of the DES-exposed group and 25 subjects of the control group showed that 26 % of the DES-exposed group produced an ejaculate volume under 1.5 ml ; no such cases were observed in the control group . The average values for sperm density and total motile spermatozoa per ejaculate , although in the normal range , were more than two times lower in the DES-exposed group as compared to the controls . A quality score of > 10 ( “ severely pathologic semen ” ) was found in 28 % of the DES-exposed group as compared to 0 in the control group . An association of pathologic semen quality with physical abnormalities was found only in the DES-exposed group . Two cases of azoospermia , one without genital abnormalities on physical examination and one with bilateral hypotrophic testes were observed so far in the DES-exposed group . Eighteen percent of 229 DES-exposed female patients had irregular menstrual cycles ( oligomenorrhea ) as compared to 10 % of 136 controls . The history of pregnancy revealed a lower incidence of pregnancy in the DES-exposed group ( 18 % ) than in the control group ( 33 % ) . Circumferential ridges of the vagina and cervix were seen in 40 % of 229 DES-exposed females but in none of 136 controls . Colposcopic findings in the vagina revealed adenosis in 66.8 % of the DES-exposed females and in 3.6 % of the control group . Dysplastic lesions were more prevalent in the vagina and cervix of the DES-exposed subjects . No cases of cancer were observed in either the male or female offspring The 27-year follow-up is reported of 136 children whose mothers were involved in a r and omised trial of high doses of stilboestrol and ethisterone therapy during pregnancy . The children were not contacted directly . Information about them was obtained from hospitals , general practitioners , and other official sources ; and the persons who responded to our inquiries were unaware of who had been exposed to hormones in utero and whose mothers had received an inactive tablet . All children were traced .  Urogenital anomalies were reported more frequently in the hormone-exposed than the unexposed children ( 14 % and 9 % respectively ) . The earlier in pregnancy the therapy began , the higher the prevalence rate of abnormalities ( X2 for trend , p less than 0.02 ) . No malignant tumours were reported . For males , the proportion reported to be married or living as married was lower in the exposed than in the unexposed group ( 32 % and 62 % respectively ) . The proportion was lower the earlier in pregnancy hormonal exposure occurred and the higher the total hormone dose to which they were exposed ( X2 for trend , p less than 0.02 ) . These findings suggest that some interference with sexual function may not be uncommon in males exposed to high doses of stilboestrol and ethisterone  while in utero OBJECTIVE --To investigate the incidence of spontaneous abortion in a population of women in order to establish their risk of spontaneous abortion and the obstetric factors predisposing to it . DESIGN -- Prospect i ve study of women recruited by radio and poster appeal and from hospital outpatient clinics . SETTING --English provincial community . PATIENTS --630 Women from the general population intending to become pregnant . INTERVENTIONS --The viability of the pregnancy was assessed by  abdominal ultrasonography  before completion of the eighth week , and the assessment was repeated if vaginal bleeding occurred . MAIN OUTCOME MEASURE -- Spontaneous abortion or live births in women with or without a previous history of spontaneous abortion . RESULTS --The overall incidence of clinical ly recognisable spontaneous abortion before 20 weeks of gestation was 12 % ( 50/407 pregnancies ) . The risk of spontaneous abortion in each category of patient was classified with respect to the patient 's past reproductive performance and found to be influenced greatly by her previous obstetric history . In primigravidas and women with a history of consistently successful pregnancies the incidences of abortion were low ( 5 % ( 4/87 ) and 4 % ( 3/73 ) respectively ) , whereas women with only unsuccessful histories had a much greater risk of aborting the study pregnancy ( 24 % ( 24/98 ) ) , even when their sole pregnancy had ended in abortion ( 20 % ( 12/59 ) ) . The outcome of the last pregnancy also influenced the outcome of the study pregnancy ; only 5 % of women ( 5/95 ) whose previous pregnancy had been successful aborted , whereas the incidence of loss of pregnancy among women whose last pregnancy had aborted was 19 % ( 40/214 ) . CONCLUSIONS --A knowledge of the patient 's reproductive history is essential for the clinical assessment of her risk of spontaneous abortion . As the most important predictive factor for spontaneous abortion is a previous abortion , the outcome of a woman 's first pregnancy has profound consequences for all subsequent pregnancies A simple programmed thaw cycle is described , during which the endometrium is prepared with oral oestradiol , followed by a natural progesterone source . This method involves minimal blood tests and uses inexpensive medications . Originally , an i.m . progesterone-in-oil preparation was used . Although highly successful in achieving high serum progesterone concentrations , the daily injections of the oily compound were found to be problematic from the patients ' perspective . To examine the possibility of replacing the injectable progesterone with a vaginal preparation we conducted a prospect i ve r and omized study of 1 year 's duration , during which time 170 and 184 thawing cycles were done with injectable and vaginal progesterone respectively . Although the progesterone blood concentrations obtained with the injectable preparation were more than twice those obtained with the vaginal progesterone , the clinical pregnancy rates ( defined as percentage thawing cycles with gestational sac(s)/embryo transfer as demonstrated on ultrasound , 4 weeks after embryo transfer ) were similar for both groups ( 15.9 and 16.8 % respectively ) . Implantation and abortion rates were also comparable . These results agree with previous reports of higher uterine progesterone concentrations after the vaginal application . We conclude that the combination of oral oestradiol and vaginal progesterone is an effective , simple and inexpensive approach for programmed thaw cycles This prospect i ve partly-r and omized study assessed the relative efficacy of two strategies of patient management for the replacement of frozen-thawed embryos . A luteinizing hormone-releasing hormone ( LHRH ) agonist was used to induce a temporary hypogonadism in a group of patients who were then prepared for implantation by endometrial priming with hormone replacement therapy ( HRT ) : oral oestradiol valerate and then oestradiol valerate and injections of progesterone . A second group of patients had their frozen-thawed embryos replaced during their natural cycles . Of the 84 patients treated with the LHRH regimen , 80 had embryos replaced and 16 ( 20 % ) clinical pregnancies were established . Of the 78 patients treated with natural cycles , 70 had embryos replaced and 14 ( 20 % ) achieved clinical pregnancies . There were no statistical differences between the two groups in terms of age , obstetric history , duration of infertility , number of oocytes retrieved and fertilized or the number of embryos frozen following ovarian stimulation in the embryo ' generating ' cycle . In terms of pregnancy rates , both protocol s were equally effective . However , the LHRH-HRT protocol was of great value in the management of oligomenorrhoeic patients and in establishing st and ard conditions for implantation in cyclic patients In 1950 a trial was set up to evaluate the effects of large doses of stilboestrol and ethisterone on rates of fetal loss in pregnant diabetic women . Eighty women were allocated at r and om to receive the hormonal treatment and 76 to receive inactive tablets of identical appearance .  At follow-up 27 years later , information was obtained about 97 % of the women , all but four being traced . All respondents were unaware of who had received hormones . The overall mortality was 4.5 times that of women of comparable age in Engl and and Wales , most deaths being from complications of diabetes . More tumours , mainly benign , of the reproductive tract were reported in the hormone-exposed than the non-exposed group ( 14 ( 18 % ) and two ( 3 % ) respectively ) . Four cases of malignant breast disease were reported in the hormone-exposed women and none in the non-exposed . These findings support other evidence linking oestrogen treatment and breast cancer and suggesting that the latent period before the tumour becomes clinical ly apparent may be 15 years or longer Whether pregnant women with insulin-dependent diabetes mellitus have an increased risk of spontaneous abortion is controversial . To address this question , we enrolled 386 women with insulin-dependent diabetes and 432 women without diabetes before or within 21 days after conception and followed both groups prospect ively . Sixty-two diabetic women ( 16.1 percent ) and 70 control women ( 16.2 percent ) had pregnancy losses ( odds ratio , 0.99 ; 95 percent confidence interval , 0.67 to 1.46 ) . After adjustment for known risk factors for spontaneous abortion , the rate was still not significantly higher in the diabetic group ( odds ratio , 0.91 ; 95 percent confidence interval , 0.59 to 1.40 ) . Nonetheless , among the diabetic women , most of whom had good metabolic control , those who had spontaneous abortions had higher fasting and postpr and ial glucose levels in the first trimester than those whose pregnancies continued to delivery ( P = 0.01 for fasting glucose levels and P = 0.005 for postpr and ial levels ) . In the small subgroup of diabetic women with poor control , who had elevated values for glycosylated hemoglobin in the first trimester , each increase of 1 SD above the normal range was associated with an increase of 3.1 percent in the rate of pregnancy loss ( 95 percent confidence interval , 0.6 to 5.6 ) . We conclude that diabetic women with good metabolic control are no more likely than nondiabetic women to lose a pregnancy , but that diabetic women with elevated blood glucose and glycosylated hemoglobin levels in the first trimester have a significantly increased risk of having a spontaneous abortion OBJECTIVE To examine prenatal diethylstilbestrol ( DES ) exposure in relation to male reproductive outcomes . DESIGN Prospect i ve observational study . SETTING Participants were identified through record review , clinical trial participation , or an obstetrics clinic . PATIENT(S ) A total of 1,085 DES-exposed and 1,047 unexposed men . INTERVENTION(S ) Participants were exposed prenatally to DES through the mother 's obstetrics care or clinical trial participation . MAIN OUTCOME MEASURE(S ) Infertility ; never fathering a pregnancy or live birth ; number of pregnancies or live births fathered . RESULT ( S ) We found little evidence that prenatal DES exposure affects the likelihood of never fathering a pregnancy or live birth , or influences the mean number of fathered pregnancies or live births . Our data suggest that DES-exposed men are slightly more likely to experience infertility ( relative risk [ RR ] = 1.3 , 95 % confidence interval [ CI ] = 1.0 - 1.6 ) . The DES dose and gestational timing did not influence infertility or the number of pregnancies or live births fathered , but results were inconsistent for dose effects on the likelihood of never fathering a pregnancy or a live birth . CONCLUSION ( S ) Prenatal DES exposure may be associated with a slightly increased risk of having an infertility experience , but does not increase the likelihood of never fathering a pregnancy or a live birth , or the number of pregnancies or live births fathered Abstract Objective : To estimate the miscarriage rate in a cohort of pregnant women and the final outcome of pregnancy . Design : Two year prospect i ve community study . Setting : Women registered with four semirural practice s at one health centre . Subjects : 626 pregnant women from a population 21 448 , 5140 of whom were women aged 15 - 
    Output:
    
There is an insufficient evidence from r and omised controlled trials to assess the use of combined oestrogen and progesterone for preventing miscarriages .