PIP: This report reviews existing evidence concerning the associationg between spermicide use and congenital defects. A recent study by Jick et al. found a 2-fold increase in various congenital defects in infants born to spermicide users. These disorders fell into 4 major categories: limb reduction deformities, neoplasms, chromosomal abnormalities, and hypospadias. However, no single, well-defined syndrome was observed among the infants of spermicide users, indicating that there may not be a causal relationship. Other researchers have suggested that Jick et al.'s results may reflect sample variance or underascertainment of defect rate prevalence in the control infants. Detergent products such as nonoxynol and octoxynol are generally considered to be safe. A recent study comparing women exposed to nonoxynol in a vaginal sponge to nonexposed controls failed to detect systemic effects from the drug. It is possible, however, that carrier agents contained in spermicides may have an effect. Although the results obtained by Jick et al. should at most be considered as tentative, further epidemiologic studies are needed. Patients who wish to take added precautions can be encouraged to use condoms or diaphagms with their spermicides to more effectively prevent pregnancy from spermicide failure. If pregnancy is suspected, an early pregnancy from spermicide failure. If pregnancy is suspected, an early pregnancy test should be obtained to avoid spermicide use during early gestation.