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  • Develop comprehensive registries for clinical research, with particular emphasis on obtaining data on gestational age and birth weight, whether the preterm birth was indicated or spontaneous, the outcomes for the newborns, and perinatal mortality and morbidity. These registries must distinguish multiple gestations from singleton gestations and link multiple infants from a single pregnancy.

  • Conduct basic biological research to identify the mechanisms of preterm birth relevant to fertility treatments and the underlying causes of infertility or subfertility that may contribute to preterm delivery.

  • Investigate the outcomes for preterm infants as well as all infants whose mothers received fertility treatments.

  • Understand the impact of changing demographics on the use and outcomes of fertility treatments.

  • Assess the short- and long-term economic costs of various fertility treatments.

  • Investigate ways to improve the outcomes of fertility treatments, including ways to identify high-quality gametes and embryos to optimize success through the use of single embryos and improve ovarian stimulation protocols that lead to monofollicular development.

Recommendation II-5: Institute guidelines to reduce the number of multiple gestations. The American College of Obstetricians and Gynecologists, the American Society for Reproductive Medicine, and state and federal public health agencies should institute guidelines that will reduce the number of multiple gestations. Particular attention should be paid to the transfer of a single embryo and the restricted use of superovulation drugs and other nonassisted reproductive technologies for infertility treatments. In addition to mandatory reporting to the Centers for Disease Control and Prevention by centers and individual physicians who use assisted reproductive technologies, the use of superovulation therapies should be similarly reported.

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