National ART Surveillance System

About national ART surveillance

Currently, about 500 U.S. clinics provide ART services to patients. CDC requests data from all ART clinics in the United States and calculates standardized success rates for each clinic that reports. These success rates are shown per ART cycle or ART transfer.

Reporting requirements

The Fertility Clinic Success Rate and Certification Act of 1992 mandates that clinics performing ART annually provide data to CDC for ART procedures they perform. CDC publishes these clinic-specific success rates. CDC and the Society for Assisted Reproductive Technology (SART) maintain a list of all ART clinics known to be in operation and track clinic reorganizations and closings. A small number of clinics do not report data to CDC and are listed as nonreporters. Because most nonreporting clinics are small, we estimate that NASS contains information on about 98% of all ART cycles in the United States.

Clinics also report certification of their embryo laboratories to CDC. Currently, certification of embryo laboratories can be done by one of the two nonfederal laboratory accreditation programs: (1) the College of American Pathologists, Reproductive Laboratory Accreditation Program (CAP), and (2) the Joint Commission on Accreditation of Healthcare Organizations (JACHO). CDC does not endorse these accreditation programs, but rather provides information about each clinic's laboratory accreditation status.

The details of reporting requirements are outlined in Federal Register Notices. The current reporting requirements for the National ART Surveillance System were published as a Federal Register Notice on August 26, 2015 (80 FR 51811). Since then, CDC has published notices in the Federal Register on the following clarifications and modifications:

• December 15, 2016 (81 FR 90854)
• October 22, 2018 (83 FR 53253)
• November 5, 2019 (84 FR 59625)
• April 20, 2021 (86 FR 20496)
• June 10, 2022 (87 FR 35555)
• August 29, 2024 (89 FR 70189)

Data collection and submission

Before success rates based on live-birth delivery can be calculated, every pregnancy conceived by ART must be followed up to determine whether a birth occurred. The earliest possible date that clinics can report ART outcomes is about 9 to 10 months past the end of the reporting year, when all births have occurred. Thus, the results of all cycles started in a given year (year 1) are not known until about September or October of the following year (year 2). After ART outcomes are known, data from clinics are reported through an informatics system maintained by a CDC contractor. The data reported in NASS include:

• Patient demographics.
• Patient obstetrical and medical history.
• Infertility diagnosis.
• Clinical parameters of the ART procedure.
• Information regarding resultant pregnancies and births.

ART clinics that report data to CDC and verify reported data are considered to be in compliance with federal reporting requirements of the Fertility Clinic Success Rate and Certification Act of 1992. Clinics report information for each ART cycle they start in a given reporting year. CDC conducts data validation through yearly audits and site visits. After CDC conducts extensive data checks, the ART success rates by clinic and clinic-level datasets are published at the end of year 3.

Representatives of new clinics preparing to submit ART data and existing clinics with data submission questions can contact the NASS Help Desk by calling 1-888-650-0822.

Confidentiality protection

ART surveillance data are sensitive because they contain personal medical information about both the people undergoing ART and the children born after ART. These data are protected by an Assurance of Confidentiality under Public Health Act Section 308(d). Due to these confidentiality restrictions, access to data files is limited.

Please contact us with any questions or suggestions at ARTinfo@cdc.gov.