Assisted Reproductive Technology Surveillance System

In the United States and worldwide, assisted reproductive technology (ART) is increasingly used to overcome different types of infertility disorders. More than 60,000 infants were born from ART treatments in 2009, representing slightly more than 1% of the U.S. birth cohort. Assisted reproductive technology is associated with a substantial risk for a multiple birth delivery. 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.

Future Directions

CDC’s Division of Reproductive Health 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. 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 general birth 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 exploring the possibility of expanding the linkage process to more data sources (e.g., hospital discharge data, birth defects and cancer registries). In 2008, we expanded the data linkage project to include two additional states (Florida, Michigan). We have completed linkage of ART data with state birth certificate records for each of the three states. We envision establishing a collaborative network of 5–10 states where use of ART is common and where the state’s 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.