title: Identifying women with indicators of subfertility in a statewide population database: operationalizing the missing link in assisted reproductive technology research.
abstract: OBJECTIVE
  To identify a group of deliveries to mothers with indicators of subfertility (SUBFERTILITY).
  
  
  METHODS
  Longitudinal cohort study.
  
  
  METHODS
  Hospital.
  
  
  METHODS
  A total of 334,152 deliveries to Massachusetts mothers in a Massachusetts hospital between July 1, 2004, and December 31, 2008.
  
  
  METHODS
  None.
  
  
  METHODS
  Subfertility was defined by an indication on a current or past birth certificate or hospital utilization data of infertility or assisted reproductive technology (ART) cycle before index delivery and no indication of ART use with index delivery.
  
  
  RESULTS
  Initially, 12,367 deliveries met the inclusion criteria for SUBFERTILITY (8,019 from birth certificates, 2,777 from hospital data, 1,571 from prior ART treatment). Removing deliveries from more than one data source resulted in 10,764 unique deliveries. Removing deliveries resulting from ART treatments left 6,238 deliveries in the SUBFERTILITY category. Demographic analysis indicated that deliveries in SUBFERTILITY were more similar to those in the ART population than to those in the fertile population.
  
  
  CONCLUSIONS
  We have demonstrated the feasibility of using existing population-based linked public health data sets to identify SUBFERTILITY deliveries, and we have used ART data to distinguish ART and SUBFERTILITY births. The SUBFERTILITY category can serve as a comparison group of subfertile patients for studies of ART delivery and longitudinal health outcomes.
authors.affiliation: Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts. Electronic address: declercq@bu.edu.
authors.forename: Eugene R
authors.initials: ER
authors.lastname: Declercq
authors.affiliation: Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.
authors.forename: Candice
authors.initials: C
authors.lastname: Belanoff
authors.affiliation: Massachusetts Department of Public Health, Boston, Massachusetts.
authors.forename: Hafsatou
authors.initials: H
authors.lastname: Diop
authors.affiliation: Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.
authors.forename: Daksha
authors.initials: D
authors.lastname: Gopal
authors.affiliation: Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Hornstein
authors.affiliation: MGH Center for Child and Adolescent Health Research and Policy, Massachusetts General Hospital for Children, Boston, Massachusetts.
authors.forename: Milton
authors.initials: M
authors.lastname: Kotelchuck
authors.affiliation: Obstetrics, Gynecology and Reproductive Biology, Michigan State University, East Lansing, Michigan.
authors.forename: Barbara
authors.initials: B
authors.lastname: Luke
authors.affiliation: Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
authors.forename: Judy E
authors.initials: JE
authors.lastname: Stern
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007246:Infertility / Q000175:diagnosis* / Q000453:epidemiology*; D008137:Longitudinal Studies; D008404:Massachusetts / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods*; D027724:Reproductive Techniques, Assisted; D055815:Young Adult
keywords: Subfertility; assisted reproductive technology; population-based studies