In a case-control study to investigate whether women who use drugs to induce ovulation are at increased risk of conception of a child with a neural tube defect, 571 women who had a fetus or child with a neural tube defect, 546 women who had a fetus or child with other abnormalities, and 573 women who had an apparently normal fetus or child were questioned about infertility, fertility drug use, and related obstetric problems. The rate of maternal fertility drug use around the time of conception was not significantly higher for neural tube defects than for other abnormalities (odds ratio 1.28; 95% confidence interval 0.39, 4.51) or no abnormalities (odds ratio 0.80; 95% Cl 0.27, 2.27). Fertility drug use at any time was not significantly more frequent for neural tube defects than for other abnormalities (odds ratio 1.37; 95% Cl 0.70, 2.74) or no abnormalities (odds ratio 1.05; 95% Cl 0.56, 1.98).