CoChat
Sign Up
Cited by 53Reproductive Health and TechnologiesAssisted Reproductive Technology and Twin PregnancyReproductive Health and Contraception

Assisted reproductive technology use in the United States: a population assessment

Open access
Tierney, Katherine, Cai, Yong·2019·Fertility and Sterility
DOI 10.1016/j.fertnstert.2019.07.1323PMC PMC6986780
Open this paper in CoChat — free account

Abstract

Objective To study social and demographic differentiation of assisted reproduction technology (ART) use at the population level in the United States.Design Population-based study.Setting Not applicable.Patient(s) Women 15-49 years old in the American Community Survey and National Vital Statistics Birth Certificate data from 2010-2017.Interventions Not applicable.Main outcome measure(s) Birth rate after ART by major sociodemographic categories and likelihood of having an ART birth.Result(s) Net of education, age, period, and marital status, the incidence rates of ART births are lower for black women (0.57 times; 95% CI, 0.52-0.62) and Hispanic women (0.67 times; 95% CI, 0.57-0.62) relative to white women's rates; for Asian women, the incidence rates are 1.21 times that of white women's rates. Further, the incidence rates of ART births are higher for women with more than a 4-year degree (2.08 times; 95% CI, 1.90-2.27) relative to women with a 4-year degree, and are lower for women with less education. Women who are married have an incidence rate of ART that is 5.72 times (95% CI, 5.37-6.09) that of unmarried women. The incidence rates for 2013-2016 are statistically significantly higher than for 2010 by a factor of 1.16 (95% CI, 1.02-1.31), 1.16 (95% CI, 1.03-1.31), 1.27 (95% CI, 1.12-1.43), and 1.51 (95% CI, 1.43-1.82), respectively. The educational differences in ART exist across all age groups from 20 to 49, but are the largest among the 35-39 and 40-44 age groups.Conclusion(s) Large differences in the risk of an ART birth and the proportion of births and the total fertility rate due to ART exist across period, age, race, education, and marital status groups in the United States. Current measures of ART births may disguise an unmet need for ART.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/j.fertnstert.2019.07.1323

Cites

31 of 31 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The use of assisted reproductive technology may have contributed to the elevated maternal mortality observed in this study among older women.

    “its use may have contributed to the elevated maternal mortality observed in our study among older women”

    From Age-related disparities in national maternal mortality trends: A population-based study (2025) · cites this paper as [44]

    The Results (Age-specific Fertility Rates; page not available) show that the proportion of births attributable to ART increased, particularly among older women. The paper measures ART births, not maternal mortality, and does not assess whether ART contributed to the elevated mortality observed in the citing study. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • In the US, assisted reproductive technology has been associated with an elevated risk of maternal mortality.

    “In the US, ART has been associated with an elevated risk of maternal mortality [43, 44]”

    From Age-related disparities in national maternal mortality trends: A population-based study (2025) · cites this paper as [44]

    The Main Outcome Measure(s) and Results sections address ART birth rates and who has ART births, not maternal mortality. Searches of our copy for “maternal mortality” and “maternal death risk” found no passage assessing an association between ART and maternal mortality in the US. (LLM, conf=0.75)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Tierney, K., & Cai, Y.
Affiliations
University of North Carolina at Chapel Hill (US)
Corresponding author
Tierney, Katherine
ORCID
Venue
Fertility and Sterility
Publisher
Elsevier BV
Published
2019-12
Volume
112
Issue
6
Pages
1136-1143.e4
ISSN
0015-0282 (ISSN-L)
DOI
10.1016/j.fertnstert.2019.07.1323
PMC
PMC6986780
OpenAlex
W2996748246
Cited by
53
References
31
Citations by year
2026: 9 · 2025: 12 · 2024: 13 · 2023: 8 · 2022: 4 · 2021: 6 · 2020: 1
FWCI
2.63
Type
journal article
Language
en
Open access
Licence
Locations
  • Fertility and Sterility (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development
  • National Science Foundation
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Assisted Reproductive Technology and Twin Pregnancy
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
Keywords
assisted reproduction, sociodemographic disparities, racial disparities, Hispanic women, Black women, Asian women, educational attainment, marital status, age differences, fertility trends, birth rate, total fertility rate, United States fertility, American Community Survey, birth certificate data, period effects
MeSH terms
Adolescent, Adult, Age Factors, Educational Status, Female, Humans, Infertility, Middle Aged, Pregnancy, Socioeconomic Factors, Time Factors, United States, Treatment Outcome, Marital Status, Reproductive Techniques, Assisted, Racial Groups, Live Birth, Healthcare Disparities, Young Adult, Social Determinants of Health

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review