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American Journal of Epidemiology Advance Access originally published online on March 10, 2007
American Journal of Epidemiology 2007 165(12):1380-1388; doi:10.1093/aje/kwm035
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American Journal of Epidemiology Copyright © 2007 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

ORIGINAL CONTRIBUTIONS

Pregnancy Loss among Pregnancies Conceived through Assisted Reproductive Technology, United States, 1999–2002

Sherry L. Farr1, Laura A. Schieve2 and Denise J. Jamieson1

1 Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, US Centers for Disease Control and Prevention, Atlanta, GA
2 National Center on Birth Defects and Developmental Disabilities, US Centers for Disease Control and Prevention, Atlanta, GA

Correspondence to Dr. Sherry L. Farr, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop K-34, Atlanta, GA 30341 (e-mail: SFarr{at}cdc.gov).

Received for publication July 14, 2006. Accepted for publication November 30, 2006.

Approximately 30% of pregnancies in the United States may end in miscarriage or stillbirth. Whether pregnancies conceived through assisted reproductive technology (ART) are at an increased risk of loss is inconclusive, and data on maternal age-, ART type-, and gestational age-specific risk of loss are limited. Data on 148,494 ART pregnancies conceived from 1999 through 2002 were analyzed by use of the Kaplan-Meier method to estimate risks of pregnancy loss after specified gestational ages (conditional risk) for 14 groups stratified by maternal age and ART procedure. Births, maternal deaths, and induced abortions were censored. The Kaplan-Meier estimate of total risk of pregnancy loss was 29% but ranged from 22% to 63% depending on patient age and ART procedure. By 6 weeks' gestation, 58% of all pregnancy losses occurred. Conditional risk of pregnancy loss ranged from 10% to 45% at 6 weeks' gestation and from 2% to 7% at the first trimester; it was less than 2% after 20 weeks' gestation. Results can be used to counsel ART patients and inform future research on the etiology of pregnancy loss.

abortion, spontaneous; fetal death; maternal age; reproductive techniques, assisted; stillbirth

Abbreviations: ART, assisted reproductive technology; CDC, US Centers for Disease Control and Prevention; ICSI, intracytoplasmic sperm injection; SART, Society for Assisted Reproductive Technology


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