Danbury Hospital Researcher Co-authors Vital Fertility Study
Danbury Hospital Assistant Director of Research Joann Petrini, PhD, has co-authored a study with the Centers for Disease Control and Prevention (CDC) that sheds light on the magnitude and potential risks of so called “fertility drugs.”
Since the miracle of the Dionne quintuplets in Canada during the Depression, multiple births have fascinated the world. Witness the media frenzy surrounding the 1997 births of McCauley children, the world’s only surviving septuplets, the eight children of Kate and Jon of reality TV fame, and more recently, the Octo-mom.
The Dionnes were the result of nature (1 in 57 million odds); the McCauleys took fertility drugs; Kate Gosselin underwent interuterine insemination, and Nadya Suleman’s embryos were implanted.
The CDC monitors multiple births occurring from artificial reproductive methods such as the embryo implantation Nadya Suleman underwent, but no such regulation exists for other fertility treatments.
What the Vital Fertility Research Shows
Infertility treatments can be grouped into 2 basic types:
- assisted reproductive technology (ART) which involves the manipulation of both egg and sperm in the lab, and
- non-ART treatments in which ovulation induction medications are used with either timed intercourse or assisted insemination.
Both types of treatment are associated with an increased risk of multiple births (twins, triplets and higher), which have higher rates of preterm birth, low birthweight and pregnancy/birth complications as well as a greater risk of complications for single babies as well. On average, about half of all twins will be preterm and over 90 percent of triplets will be preterm.
The Importance of Monitoring Infertility Treatments
The various types of infertility treatments have greatly benefitted the growing number of couples experiencing infertility. However, the dramatic increase in multiple births in the United States has been partly attributed to the growing use of infertility treatments. Therefore, it is critical that we have a means to monitor the use and outcomes of these therapies.
The Centers for Disease Control and Prevention (co-authors of this study) maintains the National ART Surveillance System, a population-based registry of ART treatments. Providers of ART (usually reproductive endocrinologists) in the US submit information on all ART procedures initiated and any resultant pregnancies and births. Unfortunately, no similar system exists for non-ART infertility treatments. The aim of this paper was to estimate the proportion of infants born annually who are conceived by non-ART treatments. Having this information allows us to track outcomes associated with pregnancies conceived through these methods.
The study found that 4.6 percent of live births in 2005 resulted from fertility drug use, a figure 4 times higher than the 1.2 percent of births resulting from ART. A total of 22.8 percent of infants born as multiple-births were conceived by using non-ART ovulation stimulation treatments. The study authors conclude that more than 190,000 infants per year are conceived with fertility drug use, but also say this figure is an underestimate because there is no system for population-based surveillance of births resulting from fertility drug treatment. Such a system would be critical in monitoring the efficacy of the medications as well as any associated health risks for the women treated and the babies conceived with these therapies.
Petrini’s article, in the American Journal of Epidemiology’s December 2009 issue is called Estimation of the Contribution of Non-Assisted Reproductive Technology Ovulation Stimulation Fertility Treatments to US Singleton and Multiple Births. The lead author is Laura A. Schieve and is also co-authored by Owen Devine, Coleen A. Boyle and Lee Warner all of the Centers for Disease Control and Prevention.
Petrini, a Brookfield resident who joined the hospital in July, was formerly the director of the Perinatal Data Center in the Office of the Medical Director at the National March of Dimes Defects Foundation in New York and is Associate Clinical Professor in Obstetrics & Gynecology and Women’s Health at Albert Einstein College of Medicine in the Bronx.
Fertility Research Study Affects the Delivery of Quality Patient Care
Shohreh Shahabi, MD, chair of Obstetrics and Gynecology at Danbury Hospital, called Petrini's research "a very important contribution." "It is an outstanding piece of research in collaboration with the CDC which makes it all the more prestigious," Shahabi added. "This research will provide the fuel to show that it’s even more important than ever to monitor non-ART procedures."
Petrini has co-authored several peer-reviewed publications and conducts presentations at national professional conferences. She was the 2002 recipient of the National Maternal and Child Health Epidemiology Young Professional Achievement Award. Because there is no national registry or oversight of non-ART treatments or births, Petrini and her colleagues used "modeling" estimation based on studies to come up with their conclusions in the year-long study.
About Danbury Hospital
Danbury Hospital is a 371-bed regional medical center and university teaching hospital associated with the University of Vermont College of Medicine, the Yale University School of Medicine, the Connecticut School of Medicine and Columbia University Medical Center. The hospital provides centers of excellence in cardiovascular services, cancer, weight loss surgery, orthopedics, digestive disorders, radiology and diagnostic imaging. It also offers specialized programs for sleep disorders and asthma management. Medical staff members are board-certified in their specialties, and most serve on the faculty of the nation’s finest medical centers offering a higher level of experience.
Danbury Hospital Women's and Children's Services is committed to the unique health needs of women and children. With a program nationally ranked in the Top 5% for excellence in Women's Health, Danbury Hospital is one of two hospitals in the state with a Level IIIb Neonatal Intensive Care Unit (NICU) that include highly-skilled nursing staff, neonatologists and the most technologically advanced equipment that offers a higher level of special care and treatment to newborns and reassurance to the women and their families of our region.