At a glance
Technical notes for ART success rates by clinic
CDC began collecting data on assisted reproductive technology (ART) procedures performed in fertility clinics in the United States in 1995. The first report describing 1995 ART cycles was published in 1997. This report, however, included data from fewer clinics, primarily members of the Society for Assisted Reproductive Technology (SART). Subsequent reports included data from nearly all fertility clinics performing ART in the United States. Reports included the complete list of clinics that provided ART, including nonreporting clinics. The proportion of nonreporting clinics among all fertility clinics since 1996 has ranged from 6.0% to 11.8%.
Starting with the 2010 ART reporting year, CDC began estimating the proportion of all ART cycles that were reported to the National ART Surveillance System (NASS). Nonreporting clinics are typically smaller (perform fewer ART cycles annually) than reporting clinics. CDC estimates the proportion of all ART cycles reported represents 97%-98% of all ART cycles performed.
ART success rates for patient's using their own eggs (nondonor cycles) are presented stratified by patient's age. Over the years, patient's age stratification groups changed:
- 1995-1996: <35, 35-39, >39 years
- 1997-1998: <35, 35-37, 38-40, >40 years
- 1999-2006: <35, 35-37, 38-40, 41-42 years
- 2007-2010: <35, 35-37, 38-40, 41-42, 43-44 years
- 2011-2018: <35, 35-37, 38-40, 41-42, 43-44, >44 years
- 2019-current: <35, 35-37, 38-40, >40 years
Standardized ART success rates are published for each reporting clinic. Over time, different measures of ART success have been included.
Initially (1995-2016 Fertility Clinic Success Rates Reports), clinic-specific summary tables were provided to include noncumulative success rates for: fresh ART cycles among patients using their own eggs, frozen ART cycles among patients using their own eggs, and donor ART cycles.
The percentage of transfers resulting in singleton live births was first included in the 2001 ART Fertility Clinic Success Rates Report. Starting with the 2011 ART Fertility Clinic Success Rates Report, ART success rates for patients using their own eggs were presented per cycle, per transfer, and per pregnancy. Starting with the 2013 ART Fertility Clinic Success Rates Report, the percentage of transfers resulting in term, normal weight, singleton live births was also included.
Starting with the 2017 ART Fertility Clinic Success Rates Report, cumulative success rates were introduced as part of the clinic summary table for all patients using their own eggs, as well as for new (no prior ART cycles) patients using their own eggs. Noncumulative success rates continued to be presented for donor cycles. Please see How to Interpret ART Success Rates to learn more.
To reduce the risk of patient identification, starting in the 2018 ART Fertility Clinic Success Rates Report, CDC implemented data suppression rules that suppress the publication of small numbers (1–4). Starting with 2019 Report, clinic-specific ART success rates are only reported in the ART Success Rates by Clinic online application instead of in an annual report.
Technical notes for ART national summary figures
CDC pools data from all reporting clinics to create national summary figures that describe ART use and outcomes. The national summary figures are noncumulative and are based only on ART cycles performed in that reporting year. For ART cycles performed in a reporting year, the pregnancy outcomes may have occurred in that year or the following year.
National summary figures were included in the ART Fertility Clinic Success Rate Reports for reporting years 1995-2009 and 2019-2021. From reporting years 2010 to 2018, the ART national summary figures were published in a separate stand-alone document.
For reporting years 1995 to 2016, national summary figures for fresh and frozen ART cycles were provided separately. Beginning with 2017 reporting year, national summary figures for fresh and frozen ART cycles were reported together, and the number of figures was significantly reduced.
Starting with reporting year 2022, the ART national summary figures are reported online as a dashboard. The national summary figures include ART cycles that used fresh or frozen embryos from a female patient's own eggs or eggs from another woman (donor eggs).
Technical notes for state-specific ART surveillance
In 2002, the Morbidity and Mortality Weekly Report (MMWR) published the first report describing ART data by state for reporting years 1996 and 1998: Use of Assisted Reproductive Technology — United States, 1996 and 1998. The annual publication of state-specific surveillance summaries in MMWR began in 2003: Assisted Reproductive Technology Surveillance — United States, 2000, describing ART cycles performed in 2000, and continued until reporting year 2018. For reporting year 2019, CDC transitioned from publishing state-specific surveillance data in the MMWR to Data Brief publications on the Division of Reproductive Health's website for more timely dissemination of the data: State-Specific ART Surveillance, United States 2019 Data Brief.
Beginning with Assisted Reproductive Technology Surveillance – United States, 2009, state-specific ART surveillance summaries have provided information on the number and outcomes of ART procedures performed in a reporting year and have also provided comparisons of ART-conceived births to all U.S. births for such outcomes as multiple births (including twins, triplets and higher order multiples), preterm births, and low birthweight infants. ART-conceived births that occur in a reporting year may result from ART procedures performed in the reporting year or the previous reporting year. When ART births are compared with all U.S. births, the source of data on the number of infants born by state is CDC's Vital Statistics Online Data Portal.
Data are presented on all cycles initiated with the intent to transfer at least one embryo, including transfer cycles that used thawed embryos. All cycles in which egg or embryo banking (freezing) was performed for future ART cycles are excluded. Data on ART cycles and birth outcomes are presented by patient's residence (state or territory) at the time of treatment, which might not be the same as the location where the procedure was performed. If information on a patient's residence was missing, residence was assigned as the location where the procedure was performed. Major changes that make certain estimates not directly comparable across state-specific surveillance summaries are described below:
- Beginning with the 2017 reporting year, state-specific data on single-embryo transfer (SET) rates among all embryo transfer cycles performed are presented instead of elective SET (eSET) rates among patients who used fresh embryos from their own fresh eggs.
- Beginning with the 2020 reporting year, the denominator for calculating ART cycles performed per million reproductive age women (a proxy measure of ART use) changed from the number of women aged 15–44 years to the number of women aged 15–49 years. This change was made because approximately 5% of ART users are older than 44 years.
Previous year reports for state-specific ART surveillance can be found on CDC Stacks.
Starting with reporting year 2022, key state-specific ART surveillance figures and tables are published online. The dashboard presents data for the 50 U.S. states, the District of Columbia, and Puerto Rico.
Please contact us with any questions or suggestions at ARTinfo@cdc.gov.