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In the United States and worldwide, assisted reproductive technologies (ARTs) are increasingly used to overcome all types of infertility disorders. More than 54,000 infants were born from ART treatments in 2006, representing more than 1% of the U.S. birth cohort. Assisted reproductive technology (ART) is associated with a substantial risk for multiple birth. Multiple birth is associated with poor infant and maternal health outcomes, including pregnancy complications, preterm delivery, low birth weight, congenital malformations, and infant death. As more women seek medical assistance to overcome their infertility it becomes important to ensure the safety of medical technology used and to continue research into the causes and prevention of infertility. The ART team works to achieve its goals through surveillance and epidemiologic research; training, technical assistance, consultation and collaboration with partners; the development of definitions, and standards; and informing public policy.

Reporting fertility clinic success rates

The Fertility Clinic Success Rate and Certification Act  (FCSRCA) of 1992 mandates that clinics performing ART annually provide data for all procedures performed to CDC. CDC is required to publish success rates for each clinic. The CDC uses the data to report clinic-specific success rates. The first joint report, The 1995 Assisted Reproductive Technology Success Rates Report, was released in December 1997. Since then, the team has continued to publish Assisted Reproductive Technology Success Rates Reports annually. The twelfth report, the 2006 Assisted Reproductive Technology Success Rates, was released in December 2009, CDC's Division of Reproductive Health has also published an MMWR Surveillance Summary on ART procedures performed in 2000, 2001, 2002, 2003, 2004 and 2005. These reports supplement the annual success rates report, providing state-specific information on ART use, number of infants, and multiple births resulting from ART. In addition, data from the surveillance system have been used to perform more in-depth analyses of risks associated with ART, particularly multiple births and low birth weight.

Future Directions

The CDC will explore mechanisms to better assess the potential for short-and long-term health effects associated with ART women, infants, and families. In 2001 CDC began a collaborative project with the Massachusetts Department of Public Health to explore the possibility of linking ART data with birth certificate and death certificate records. The main objective was to—

1. create a population-based dataset of ART mother-infant pairs with information on both conception and delivery, and
2. compare this with similar data from other mother-infant pairs in the population.

This project strengthens our capacity to evaluate maternal and infant outcomes of ART. The results of the project indicate that systematic assessment of certain adverse outcomes is feasible through linkage of the ART data with existing vital statistics and health care information systems. To develop surveillance data on maternal and infant health outcomes after ART, we are discussing the possibility of expanding the linkage process to more information items (e.g., hospital discharge summaries) and more states. We envision establishing a collaborative network of 5–10 states where use of ART is common and where vital statistics records allow linkages. Such a network would be a first and important step toward developing a national surveillance system of ART maternal and infant health outcomes.

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Page last reviewed: 3/26/09
Page last modified: 3/26/09
Content source: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion