Assisted Reproductive Technology Surveillance - United States, 2001

Abstract

Problem/Condition: Since the first U.S. infant conceived with assisted reproductive technology (ART) was born in 1981, both the use of ART and the number of fertility clinics providing ART services have increased steadily in the United States. ART includes fertility treatments in which eggs or embryos are handled in the laboratory (i.e., in vitro fertilization [IVF] and related procedures). Women who undergo ART procedures are more likely than women who conceive naturally to deliver multiple-birth infants. Multiple births pose substantial risks to both mothers and infants, including obstetric complications, preterm delivery, and low birthweight infants. This report provides state-specific information for the United States (including the District of Columbia and Puerto Rico) on ART procedures performed in 2014 and compares birth outcomes that occurred in 2014 (resulting from ART procedures performed in 2013 and 2014) with outcomes for all infants born in the United States in 2014. Period Covered: 2014. Description of System: In 1996, CDC began collecting data on ART procedures performed in fertility clinics in the United States as mandated by the Fertility Clinic Success Rate and Certification Act of 1992 (FCSRCA) (Public Law 102-493). Data are collected through the National ART Surveillance System (NASS), a web-based data collection system developed by CDC. This report includes data from 52 reporting areas (the 50 states, the District of Columbia, and Puerto Rico). Results: In 2014, a total of 169,568 ART procedures (range: 124 in Wyoming to 21,018 in California) with the intent to transfer at least one embryo were performed in 458 U.S. fertility clinics and reported to CDC. These procedures resulted in 56,028 live-birth deliveries (range: 52 in Wyoming to 7,230 in California) and 68,782 infants born (range: 64 in Wyoming to 8,793 in California). Nationally, the total number of ART procedures performed per million women of reproductive age (15-44 years), a proxy measure of the ART usage rate, was 2,647 (range: 364 in Puerto Rico to 6,726 in Massachusetts). ART use exceeded the national average in 13 reporting areas (Connecticut, Delaware,

Comparison of embryological and clinical outcome in GnRH antagonist vs. GnRH agonist protocols for in vitro fertilization in PCOS non-obese patients. A prospective randomized study

“…Some studies previously reported lower conception rates in PCOS women undergoing ovulation induction [42]. This could not be confirmed in the current study, especially when compared with mean pregnancy rates after ICSI per transfer in the European (28.7%) and American studies (41%) [43,44]. Although miscarriage rate in our study did not differ between both studied groups, we observed tendency to higher number of miscarriages in GnRH antagonist than in GnRH agonist group (18% vs. 8%, respectively).…”

Should a patient's own IVF physician perform the embryo transfer?

“…Additionally, patients often view their involve-ment with the physician at the time of key procedures to be a marker of success or "good luck" for that procedure. As in vitro fertilization (IVF) gains increased utilization [1], efficiency of a busy IVF unit requires a team physician approach that involves multiple physicians being involved in the course of a patient's cycle and procedures. This process may seem daunting to patients who are familiar with a specific physician's care.…”

Assessing the Risk of Cerebral Palsy in Children Born after Assisted Conception – The Role of Multiple Pregnancy and Preterm Delivery / Procena rizika od cerebralne paralize kod dece začete vantelesnim oplođenjem – uloga višestruke trudnoće i prevremenog rođenja

“…However, this study was focused on singleton births only, so the results and conclusion should be interpreted with caution due to exclusion of previously confirmed increased incidence of preterm and multiple births in IVF pregnancies (4,6,(16)(17)(18)(19)(20)(28)(29)(30)(31).…”

“…Since then, more than two million babies have been delivered worldwide through the use of ART procedures (2). In vitro fertilization treatment alone now accounts for an estimated 1% of all births in the United States of America (3,4) and 1% to 4% of births in European countries (5) with a proven increase of the percentage of IVF singletons and twins from 1.4% in 1995 to 3.0% in 2000, with an average of 2.3% (6).…”

“…Procedures of ART are usually defined as fertility treatments in which both egg and sperm are manipulated in the laboratory, such as IVF and intracytoplasmic sperm injection (ICSI) (7). In both ART treatments, fertilized eggs are implanted after several days of ex vivo cell growth (8).…”