domingo, 20 de julio de 2014

CDC - Infertility & Public Health - Reproductive Health

CDC - Infertility & Public Health - Reproductive Health

Division of Reproductive Health Global Activity eUpdate

The National Public Health Action Plan for the Detection, Prevention, and Management of Infertility is now available. The plan identifies opportunities for reducing infertility and its causes in the United States. The National Action Plan is related to the White Paper, A Public Health Focus on Infertility Prevention, Detection and Management.

The August 19th CDC Public Health Grand Rounds will include information about the National Action Plan and other public health efforts focusing on infertility. Please save this date on your calendar.

Thank you for your interest in this important public health issue.

Infertility and Public Health

A National Public Health Action Plan for the Detection, Prevention, and Management of Infertility

cover for National Public Health Action Plan publication

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[PDF - 5.24MB]

In consultation with many governmental and nongovernmental partners, the Centers for Disease Control and Prevention (CDC) developed the National Public Health Action Plan for the Detection, Prevention, and Management of Infertility (hereafter called the National Action Plan or the Plan). This plan highlights the need to better understand and address issues at a population level that contribute to and are caused by infertility in women and men and that may affect the health of the pregnancy.

Specifically, this plan focuses on:

Promoting healthy behaviors that can help maintain and preserve fertility.
Promoting prevention, early detection, and treatment of medical conditions that can threaten fertility.
Reducing exposures to environmental, occupational, infectious, and iatrogenic agents that can threaten fertility.

Because of its public health focus, these strategies also call for promoting healthy pregnancy outcomes associated with treating and managing infertility and improving the safety and efficacy of infertility treatments.

The findings and recommendations contained in this publication may serve as a platform to stimulate discussion and collaboration among Federal agencies, professional organizations, academic institutions, and those who represent consumers of health services.

Learn more about CDC's Infertility Activities and Programs.

To receive e-mail updates about this activity, please enter your e-mail address in the “Get e-mail updates” box to the right.

What is Assisted Reproductive Technology?

Although various definitions have been used for ART, the definition used by CDC is based on the 1992 Fertility Clinic Success Rate and Certification Act that requires CDC to publish the annual ART Success Rates Report. According to this definition, ART includes all fertility treatments in which both eggs and sperm are handled. In general, ART procedures involve surgically removing eggs from a woman’s ovaries, combining them with sperm in the laboratory, and returning them to the woman’s body or donating them to another woman. They do NOT include treatments in which only sperm are handled (i.e., intrauterine—or artificial—insemination) or procedures in which a woman takes medicine only to stimulate egg production without the intention of having eggs retrieved.

ART has been used in the United States since 1981 to help women become pregnant, most commonly through the transfer of fertilized human eggs into a woman’s uterus (in vitro fertilization). However, deciding whether to undergo this expensive and time-consuming treatment can be difficult. Learn more about ART patient resources.

Most Recent ART Data

According to CDC’s 2012 ART Fertility Clinic Success Rates Report, 176,247* ART cycles were performed at 456 reporting clinics in the United States during 2012, resulting in 51,267 live births (deliveries of one or more living infants) and 65,160 live born infants. Although the use of ART is still relatively rare as compared to the potential demand, its use has doubled over the past decade. Today, over 1% of all infants born in the United States every year are conceived using ART.

* Note: This number does not include 27 cycles in which a new treatment procedure was being evaluated.

Download the 2012 Data—Clinic Tables and Data Dictionary

[XLS - 1.41MB]

15 Years of ART Surveillance

ART can alleviate the burden of infertility on individuals and families, but it can also present challenges to public health as evidenced by the high rates of multiple delivery, preterm delivery, and low birth-weight delivery experienced with ART. Monitoring the outcomes of technologies that affect reproduction, such as contraception and ART, has become an important public health activity.

CDC’s Division of Reproductive Health has a long history of surveillance and research in women’s health and fertility, adolescent reproductive health, and safe motherhood. In response to congressional mandate, CDC began work to strengthen existing data collection efforts initiated by the American Society for Reproductive Medicine (ASRM)

and the Society for Assisted Reproductive Technology (SART)

and to develop a national system for monitoring ART use and outcomes.

In 1997, CDC submitted to Congress the first annual report, titled Assisted Reproductive Technology Success Rates: National Summary and Fertility Clinic Reports. This report gained a wide audience, including potential ART patients and their families, policy makers, researchers and health care providers. Maternal and child health professionals, as well as state and local public health departments, also began requesting data on birth outcomes among infants born using ART technologies in their localities. In 2002, CDC prepared the first ART surveillance report on ART use and outcomes by state. The ART Surveillance Summary is now published as a supplement to CDC’sMorbidity and Mortality Weekly Report (MMWR). Learn more about National ART Surveillance.

Expanding the Scope of ART Outcomes Research

The National ART Surveillance System (NASS) does not contain information on long-term outcomes of ART. This information can be obtained by linking ART surveillance data with other surveillance systems and registries, while paying close attention to confidentiality protection. Since 2001, CDC has collaborated with health departments of three states (Massachusetts, and later Michigan and Florida), to link NASS with vital records, hospital discharge data, birth defects registries, cancer registries, and other surveillance systems of these states. This project, called States Monitoring ART (SMART) Collaborative, provides a unique opportunity for federal and state public health agencies to work together on establishing state-based public health surveillance of ART, infertility and related issues. Learn more about the SMART Collaborative.

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