Protocol - Mode of Conception - Interview
A woman who gave birth is asked several questions about the amount of time she spent trying to become pregnant and if she used fertility drugs or reproductive technologies to help her get pregnant.
The maternal interview may provide information about medical interventions to achieve pregnancy. Information from the maternal interview complements the information obtained from the Mode of Conception - Medical Record Abstraction protocol and ideally, both modes of administration are used. The maternal interview may yield inaccurate information due to potential recall bias.
1) When you got pregnant with your new baby, were you trying to get pregnant?
[ ] 1 No
[ ] 2 Yes
(IF NO, THEN SKIP ALL THE REMAINING QUESTIONS AND CODE THAT CONCEPTION WAS "SPONTANEOUS" OR "NATURAL)
2) Did you (or your partner) take any fertility drugs or receive any medical procedures from a doctor, nurse or other health care worker to help you get pregnant with (this pregnancy/your new baby/child’s name)? This may include infertility treatments such as fertility-enhancing drugs or assisted reproductive technology. (italics added by MK)
[ ] 1 No
[ ] 2 Yes
(IF NO, THEN SKIP TO QUESTION 6 AND CODE THAT CONCEPTION WAS "SPONTANEOUS" OR "NATURAL")
3) Did you (or your partner) use any of the following fertility treatments during the month you got pregnant with (this pregnancy/your new baby/child’s name)?
Check ALL that apply (italics added by MK)
[ ] Fertility enhancing drugs prescribed by a doctor (fertility drugs include Clomid®, Serophene®, Pergonal® or other drugs to stimulate ovulation)
[ ] Artificial insemination or intrauterine insemination (treatments in which sperm, but NOT eggs, were collected and medically placed inside the woman’s body)
[ ] Assisted reproductive technology (treatments in which BOTH a woman’s eggs and a man’s sperm were handled in the laboratory, such as in vitro fertilization [IVF],
gamete intrafallopian transfer [GIFT], zygote intrafallopian transfer [ZIFT], intracytoplasmic sperm injection [ICSI], frozen embryo transfer, or donor embryo transfer)
[ ] Other medical treatment (please tell us) ________________________
[ ] I wasn’t using fertility treatments during the month that I got pregnant with (this pregnancy/my new baby/child’s name)
4) How long had you been trying to get pregnant before you took any fertility drugs or used any medical procedures to help you get pregnant with (this pregnancy/your new baby/child’s name)? Do not count long periods of time when you and your partner were apart or not having sex.
[ ] 0 to 5 months
[ ] 6 to 11 months
[ ] 1 to 2 years
[ ] 3 to 4 years
[ ] 5 to 6 years
[ ] More than 6 years
5) How many cycles of fertility treatments (complete or incomplete) did you have before you got pregnant with your new baby?
[ ] 1 cycle
[ ] 2 to 3 cycles
[ ] 4 to 6 cycles
[ ] 7 or more cycles
ONLY ASK QUESTION 6 IF QUESTION 2 IS ANSWERED "NO"
6) How many months were you trying to get pregnant? Do not count long periods of time when you and your partner were apart or not having sex.
[ ] 0 to 3 months
[ ] 4 to 6 months
[ ] 7 to 12 months
[ ] 13 to 24 months
[ ] More than 24 months
Protocol Name from Source:
Pregnancy Risk Assessment Monitoring System (PRAMS) Phase 7 Core Questions and Standard Questions
Personnel and Training Required
No specific training is needed if data are collected through a self-administered questionnaire. If interviewers administer the questionnaire, the interviewer must be trained to conduct personal interviews with individuals from the general population and found competent to administer these particular questions (i.e., tested by an expert) at the end of the training. The interviewer should be trained to prompt respondents further if a "don’t know" response is provided.
These questions can be administered in a computerized or noncomputerized format (i.e., paper-and pencil instrument). Computer software is necessary to develop computer-assisted instruments. The interviewer will require a laptop computer or handheld computer to administer or to allow the respondent to self-administer a computer-assisted questionnaire.
|Specialized requirements for biospecimen collection||No|
|Average time of greater than 15 minutes in an unaffected individual||No|
Mode of Administration
Self-administered or interviewer-administered questionnaire
Adolescent, Adult, Pregnancy
The questions were used in the Pregnancy Risk Assessment Monitoring System (PRAMS), a major ongoing study with thousands of participants.
|Common Data Elements (CDE)||Pregnancy Conception Mode Assessment Text||5633914||CDE Browser|
Process and Review
The Expert Review Panel has not reviewed this measure yet.
Centers for Disease Control and Prevention, Pregnancy Risk Assessment Monitoring System (PRAMS) Phase 7 Core Questions, Item 14, Phase 7 Standard Questions, Items A1-A4, Question 7.
Core State Preconception Health Indicators-Pregnancy Risk Assessment Monitoring System and Behavioral Risk Factor Surveillance System, 2009. (2014). Morbidity and Mortality Weekly Report, 63(ss03):1-62.
|Variable Name||Variable ID||Variable Description||Version||dbGaP Mapping|
Mode of Conception
January 31, 2017
Questions about whether medical intervention of any kind was needed to achieve pregnancy.
Information about natural or assisted conception (i.e., infertility treatments or reproductive technologies) is essential to determine fertility status.
Pregnancy, conception, fertility, infertility treatment, Extremely Low Gestational Age Newborns, ELGAN, Pregnancy Risk Assessment Monitoring System, PRAMS, Centers for Disease Control and Prevention, CDC