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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 either eggs or embryos 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 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’s Morbidity and Mortality Weekly Report (MMWR). Learn more about National ART Surveillance.
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.