Epidemiology of Fertility Treatment Use Among US Women with Liveborn Infants, 1997-2004

Objective: This study assessed reported use of assisted reproductive technology (ART) and other (non-ART) fertility treatments among a population-based sample and examined factors related to use. Methods: The data for this study were collected as part of the National Birth Defects Prevention Study (NBDPS), limited to women from the control group who delivered liveborn infants with no major birth defects. We described prevalence of the use of ART and clomiphene citrate (the most commonly used non-ART treatment) by demographic and lifestyle factors and examined associations among use of fertility treatments and pregnancy outcomes, timing of prenatal care initiation, and use of prenatal testing technologies. Results: Overall, 4.2% of women reported any type of maternal fertility treatment use; 1.0% reported ART use, 1.6% reported clomiphene citrate use without ART, and 1.7% reported other fertility treatments. Women who reported any fertility treatment type were more likely than women with an unassisted conception to be non-Hispanic white, >30 years of age, and more highly educated. Overall, women who reported ART use were more likely than women who reported unassisted pregnancy to have an amniocentesis; however, this association was no longer evident after adjustment for maternal age. Conclusions: Fertility treatment use and type of treatment vary by maternal characteristics. This information may be useful to inform a broad maternal and child health audience about the growing use of fertility treatments, including who is using the treatments and the choices they are making about prenatal care.