Fertility of women after exposure to internal and external radiation

Fertility was examined in 199 women exposed to internal and external radiation while employed in the radium watch-dial painting industry in Illinois between 1916 and 1929. In women with at least one live birth, mean log live-birth rate was significantly lower in the highest (estimated) ovarian-dose group (i.e., greater than or equal to 20 rem) than in the lowest group (<5 rem). In multiple regression analysis, intake dose (proportional to alpha-particle dose to ovaries) but not duration of employment (relevant to external gamma-ray dose to ovaries) was a statistically significant predictor of log live-birth rate. There was no evidence for an increase in fetal deaths with increasing ovarian dose level (rem). This suggests that the findings on live-birth rate may not involve post-implantation dominant lethal mutations, but pre-implantation losses could not be evaluated. Some possible explanations for these findings are discussed