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Estimation of the Contribution of Non–Assisted Reproductive Technology Ovulation Stimulation Fertility Treatments to US Singleton and Multiple Births
American Journal of Epidemiology, 10/29/09

Schieve LA et al. – The authors developed a multistage model to estimate the uncertain proportion of US infants born in 2005 who were conceived by using non–ART ovulation treatments. Using published surveillance data, they estimated proportions of US multiple births conceived naturally and by ART and assumed that the remainder were conceived with non–ART treatments. They used Bayesian meta–analyses to summarize published clinical studies on the multiple–gestation risk associated with non–ART ovulation treatments, applied a fetal survival factor, and used this multiple–birth risk estimate and their own estimate of the proportion of US multiple births attributable to non–ART ovulation stimulation to estimate the total (and, through subtraction, singleton) proportion of infants conceived with such treatments. On the basis of the model, the authors estimate that 4.6% of US infants born in 2005 (95% uncertainty range: 2.8%–7.1%) resulted from non–ART ovulation treatments. Notably, this figure is 4 times greater than the ART contribution.