Epidemiology of infertility – surveillance and research

The National Survey of Family Growth (NSFG), conducted by the National Center for Health Statistics, provides the longest-running, nationally representative data on infertility and the use of medical care for infertility in the United States, and has been a key surveillance tool for these topics since 1973. This presentation will primarily focus on NSFG data documenting the epidemiology of infertility and impaired fecundity, as well as patterns of service use. The presentation will also describe briefly the ongoing surveillance of assisted reproductive technologies via the CDC's ART Registry. Because the NSFG relies on a household-based probability sample of men and women 15-44 in the U.S., the information collected on fertility impairments and the use of infertility services are not limited to those who are actively seeking pregnancy or who have visited medical providers for particular services. In that regard, prevalence estimates and patterns by demographic characteristics such as age, parity, and race/Hispanic origin may be more representative of the general U.S. population. Trends in infertility and the use of infertility services will be shown for women over the period 1973-2002, and will be updated to the extent possible with the newly released 2006-08 NSFG data. Since men were first included in the NSFG in 2002, less extensive trends and subgroup detail will be shown for men. In recent years, other surveys such as the National Fertility Barriers Study have contributed to the understanding of disparities and challenges in the use of infertility services, and these will be reviewed as well.