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Objective: To investigate whether cryopreservation of supernumerary embryos is a good surrogate for embryo quality., Design: Retrospective study of 6,859 assisted reproductive technology (ART) cycles from women aged <35 years with two fresh day 3 embryos transferred., Setting: National Society for Assisted Reproductive Technology Clinic Outcome Reporting System data from 2006-2008., Patient(s): Women undergoing ART., Intervention(s): None., Main Outcome Measure(s): Embryo quality (good, fair, or poor), cell number, and live births were compared for cycles with and without cryopreservation, using χ(2) to evaluate statistical significance. The association of freezing with embryo quality was examined using multiple logistic regression after adjusting for confounders (patient age, oocyte yield, intracytoplasmic sperm injection [ICSI], assisted hatching, male factor infertility)., Result(s): Cycles with cryopreservation were more likely to have two embryos of good quality transferred (81.3% vs. 48.5%) and had more 8-cell embryos transferred (76.0% vs. 50.1%). Relative to cycles with two good embryos (good-good), the adjusted odds ratios (OR) for cryopreservation were: good-fair (OR = 0.301, 95% confidence interval [CI] = 0.257-0.354), fair-fair (OR = 0.308, 95% CI = 0.258-0.367), and any poor (OR = 0.058, 95% CI = 0.040-0.083). The live birth rate was 52.4% for cycles with freezing and 40.6% for cycles without., Conclusion(s): Embryo quality and cell number were both associated with embryo cryopreservation. However, although cryopreservation was a strong marker for good quality, not having cryopreservation did not reliably indicate poor quality, as almost half of those cycles had two good quality embryos., (Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: To evaluate the determinants of intrauterine device (IUD) use and reasons for choosing IUDs over other reversible contraceptive methods., Design: Descriptive statistics and multinomial logistic regression were used to assess multiple factors associated with IUD use and the use of other reversible methods in the United States., Setting: Not applicable., Patient(s): Women at risk of pregnancy from the 2006 to 2008 National Survey of Family Growth and a 2004 Guttmacher Institute survey., Intervention(s): None., Main Outcome Measure(s): Sociodemographic and reproductive characteristics, family background, and health insurance coverage., Result(s): IUD use was positively associated with women's parity and the highest education level of respondent's mother; it was less common among women who had ≥4 sexual partners in the last 12 months and those who were widowed, divorced, or separated. IUD users reported pregnancy prevention, provider recommendation, and no interruption of sex as the most important reasons for choosing the method and reported a high level of satisfaction., Conclusion(s): IUD users differed substantially from users of other reversible contraceptives. IUD use was especially uncommon among nulliparae. Most current IUD users were satisfied with their choice., (Published by Elsevier Inc.)

Objective: To evaluate the accuracy of assisted reproductive technology (ART) reporting on the Massachusetts birth certificate and to explore the individual and hospital-level characteristics associated with ART reporting., Design: Validity analysis of population-based data., Setting: Live-birth deliveries by Massachusetts-resident mothers during 1997-2000., Patient(s): Live births and delivery mothers., Intervention(s): The ART data maintained by the Centers for Disease Control and Prevention were linked with the live birth-infant death records in Massachusetts. Successfully linked records were used as the gold standard for ART-related deliveries in evaluating the validity of the ART information reported on the Massachusetts birth certificate., Main Outcome Measure(s): Sensitivity and specificity., Result(s): The sensitivity of ART reporting on the birth certificate was 27% and the specificity >99%. Sensitivity of ART reporting was higher among women with multiple deliveries (twins: 32%; triplets+: 43%) and preterm deliveries (36%)., Conclusion(s): During the period evaluated, reporting of ART information on the birth certificate was incomplete, and ART births identified through the birth certificate were a biased sample of the population of ART births. Using delivery hospital data as the sole source of ART information for the standard birth certificate may yield inaccurate information., (Copyright © 2010 American Society for Reproductive Medicine. All rights reserved.)

In 2002, 2 million American women of reproductive age were infertile. Infertility is also common among men. The Centers for Disease Control and Prevention (CDC) conducts surveillance and research on the causes of infertility, monitors the safety and efficacy of infertility treatment, and sponsors national prevention programs. A CDC-wide working group found that, despite this effort, considerable gaps and opportunities exist in surveillance, research, communication, and program and policy development. We intend to consult with other federal agencies, professional and consumer organizations, the scientific community, the health care community, industry, and other stakeholders, and participate in the development of a national public health plan for the prevention, detection, and management of infertility., (Published by Elsevier Inc.)

Objective: To describe the extent to which men report they or their partners had made use of infertility services, what services and conditions were reported, and what factors were associated with their use of services., Design: Analysis of the male sample of the 2002 National Survey of Family Growth, a nationally-representative household survey of men 15-44. Analysis involved estimation of percentages, chi-squared tests of difference, and multivariate logistic regression analysis., Setting: The 2002 National Survey of Family Growth, Cycle 6., Patient(s): A total of 4109 sexually experienced men aged 15-44 years in the 2002 National Survey of Family Growth who had received infertility services., Intervention(s): None., Main Outcome Measure(s): Percentage of men reporting that they had sought help with having a baby., Result(s): A total of 7.5% of all sexually experienced men reported a visit for help with having a child; 2.2% reported a visit in the past year, equivalent to 3.3-4.7 million men reporting a lifetime visit and 787,000-1.5 million a past-year visit. Visits were reported more frequently by older men, those currently or previously married, and the more highly educated. Male-related infertility conditions were reported by 18.1% of those who sought help, the most frequent being sperm or semen problems and varicocele., Conclusion(s): Previous estimates of infertility help-seeking were based on data from women. Men report a percentage seeking help that appears to be somewhat lower than reported by women. About 1 in 5 of those seeking help reported male-related infertility conditions.

Objective: To determine demographic characteristics associated with pregnancy and, separately, discontinuation of infertility services when unsuccessful at achieving pregnancy, among a national sample of women who received infertility services., Design: Using a log-linear regression model, we examined associations with becoming pregnant among women who had received infertility services; and using a Cox proportional hazards model, we examined associations with earlier infertility service discontinuation., Setting: 2002 National Survey of Family Growth, Cycle 6., Participant(s): A total of 530 women aged 18-44 years in the 2002 National Survey of Family Growth who had received infertility services., Intervention(s): None., Main Outcome Measure(s): Relative risks for predictors of pregnancy after receiving infertility services; median time to discontinuation of infertility services; hazard ratios for predictors of earlier discontinuation of services., Result(s): Fifty-nine percent of respondents became pregnant while receiving infertility services, and 32% reported discontinuing infertility services before establishing a pregnancy. Women received infertility services for a median of 8 months; among those who discontinued services, more than half did so within 1 month. Among women who received infertility services, those who were white, nonsmokers, nulliparous, had insurance coverage, and received more than advice had a higher likelihood of pregnancy. Non-whites, parous women, and smokers discontinued infertility services earlier than others., Conclusion(s): Patients should be adequately counseled regarding modifiable behaviors and the range of services available before making decisions regarding their infertility.