State-Specific Assisted Reproductive Technology Surveillance, United States: 2021 Data Brief

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TABLE 4. Number, percentage, and proportion of multiple births, twins, triplets, and higher-order infants born with use of assisted reproductive technology procedures in 2021, by female patient’s reporting area of residence at time of treatment in 50 US states, the District of Columbia, and Puerto Rico
TABLE 4. Number, percentage, and proportion of multiple births, twins, triplets, and higher-order infants born with use of assisted reproductive technology procedures in 2021, by female patient’s reporting area of residence at time of treatment in 50 US states, the District of Columbia, and Puerto Rico
Patient’s reporting area of residencea Multiple-birth
infants among
ART infantsb,c		 Multiple births among all infantsd Proportion of ART multiples among all multiples Twin infants among ART infantsb,c Twin infants among all infantsd Proportion of ART twins among all twins Triplets or higher-order among ART infantsb,c Triplets or higher-order among all infantsd Proportion of
ART triplets or higher-order among all triplets
No. % No. % % No. % No. % % No. % No. % %
Alabama 59 17.4 2,149 3.7 2.7 59 17.4 2,079 3.6 2.8 0 0.0 70 0.1 0.0
Alaska 13 14.1 315 3.4 4.1 e e 306 3.3 e e e e e 33.3
Arizona 255 19.3 2,315 3.0 11.0 236 17.9 2,251 2.9 10.5 19 1.4 64 0.1 29.7
Arkansas 55 21.3 1,130 3.1 4.9 e e 1,106 3.1 e e e 24 0.1 e
California 1,347 11.8 12,189 2.9 11.1 1,302 11.4 11,925 2.8 10.9 45 0.4 264 0.1 17.0
Colorado 217 12.2 1,879 3.0 11.5 211 11.8 1,839 2.9 11.5 6 0.3 40 0.1 15.0
Connecticut 204 12.9 1,370 3.8 14.9 192 12.1 1,333 3.7 14.4 12 0.8 37 0.1 32.4
Delaware 19 6.9 326 3.1 5.8 e e 314 3.0 e e e 12 0.1 e,f
District of Columbia 24 4.8 246 2.8 9.8 24 4.8 e e e 0 0.0 e e f
Florida 515 13.9 6,532 3.0 7.9 509 13.8 6,410 3.0 7.9 6 0.2 122 0.1 4.9
Georgia 403 17.4 4,164 3.4 9.7 370 15.9 4,048 3.3 9.1 33 1.4 116 0.1 28.4
Hawaii 78 20.8 443 2.8 17.6 78 20.8 e e e 0 0.0 e e f
Idaho 90 23.4 664 3.0 13.6 84 21.9 639 2.8 13.1 6 1.6 25 0.1 24.0
Illinois 597 12.5 4,497 3.4 13.3 585 12.2 4,415 3.3 13.3 12 0.3 82 0.1 14.6
Indiana 196 17.6 2,695 3.4 7.3 190 17.0 2,634 3.3 7.2 6 0.5 61 0.1 9.8
Iowa 125 15.2 1,326 3.6 9.4 e e 1,294 3.5 e e e 32 0.1 e
Kansas 67 12.9 1,098 3.2 6.1 e e 1,058 3.0 e e e 40 0.1 e
Kentucky 114 18.1 1,751 3.4 6.5 114 18.1 1,699 3.3 6.7 0 0.0 52 0.1 0.0
Louisiana 69 9.7 1,997 3.5 3.5 69 9.7 1,949 3.4 3.5 0 0.0 48 0.1 0.0
Maine 26 10.7 373 3.1 7.0 26 10.7 e e e 0 0.0 e e f
Maryland 203 8.8 2,244 3.3 9.0 203 8.8 2,198 3.2 9.2 0 0.0 46 0.1 0.0
Massachusetts 416 11.2 2,324 3.4 17.9 407 10.9 2,271 3.3 17.9 9 0.2 53 0.1 17.0
Michigan 510 25.3 3,894 3.7 13.1 497 24.7 3,808 3.6 13.1 13 0.6 86 0.1 15.1
Minnesota 257 15.4 2,164 3.4 11.9 245 14.7 2,096 3.3 11.7 12 0.7 68 0.1 17.6
Mississippi 32 11.7 1,312 3.7 2.4 32 11.7 1,272 3.6 2.5 0 0.0 40 0.1 0.0
Missouri 159 14.0 2,320 3.4 6.9 e e 2,246 3.2 e e e 74 0.1 e
Montana 12 7.2 316 2.8 3.8 12 7.2 306 2.7 3.9 0 0.0 10 0.1 0.0
Nebraska 77 18.8 836 3.4 9.2 e e 790 3.2 e e e 46 0.2 e
Nevada 129 18.7 1,094 3.2 11.8 e e 1,068 3.2 e e e 26 0.1 e
New Hampshire 70 15.7 436 3.5 16.1 70 15.7 425 3.4 16.5 0 0.0 11 0.1 0.0
New Jersey 347 6.8 3,112 3.1 11.2 335 6.6 3,024 3.0 11.1 12 0.2 88 0.1 13.6
New Mexico 32 16.4 546 2.6 5.9 32 16.4 e e e 0 0.0 e e f
New York 866 9.9 6,905 3.3 12.5 836 9.6 6,686 3.2 12.5 30 0.3 219 0.1 13.7
North Carolina 277 12.1 3,933 3.3 7.0 277 12.1 3,867 3.2 7.2 0 0.0 66 0.1 0.0
North Dakota 18 13.0 270 2.7 6.7 18 13.0 e e e 0 0.0 e e f
Ohio 252 11.3 4,178 3.2 6.0 246 11.1 4,081 3.1 6.0 6 0.3 97 0.1 6.2
Oklahoma 120 25.5 1,552 3.2 7.7 120 25.5 1,515 3.1 7.9 0 0.0 37 0.1 0.0
Oregon 161 17.7 1,409 3.4 11.4 149 16.4 1,379 3.4 10.8 12 1.3 30 0.1 40.0
Pennsylvania 216 6.8 4,263 3.2 5.1 210 6.6 4,156 3.1 5.1 6 0.2 107 0.1 5.6
Puerto Rico 32 38.1 443 2.3 7.2 32 38.1 e e e 0 0.0 e e f
Rhode Island 30 11.7 296 2.8 10.1 e e 284 2.7 e e e 12 0.1 e,f
South Carolina 71 7.5 1,891 3.3 3.8 e e 1,840 3.2 e e e 51 0.1 e
South Dakota 19 16.5 407 3.6 4.7 e e 395 3.5 e e e 12 0.1 e,f
Tennessee 139 13.6 2,608 3.2 5.3 130 12.7 2,522 3.1 5.2 9 0.9 86 0.1 10.5
Texas 937 12.8 11,280 3.0 8.3 912 12.5 10,974 2.9 8.3 25 0.3 306 0.1 8.2
Utah 186 15.9 1,542 3.3 12.1 180 15.3 1,485 3.2 12.1 6 0.5 57 0.1 10.5
Vermont 34 21.4 165 3.1 20.6 34 21.4 e e e 0 0.0 e e f
Virginia 247 10.4 3,060 3.2 8.1 238 10.0 3,005 3.1 7.9 9 0.4 55 0.1 16.4
Washington 256 11.7 2,438 2.9 10.5 250 11.5 2,384 2.8 10.5 6 0.3 54 0.1 11.1
West Virginia 32 18.3 577 3.4 5.5 32 18.3 e e e 0 0.0 e e f
Wisconsin 161 15.3 2,060 3.3 7.8 152 14.5 1,997 3.2 7.6 9 0.9 63 0.1 14.3
Wyoming 16 17.2 203 3.3 7.9 16 17.2 e e e 0 0.0 e e f
Total 10,787 12.5 117,537 3.2 9.2 10,445 12.1 114,600 3.1 9.1 342 0.4 2,937 0.1 11.6

ART = assisted reproductive technology.

layout
a In cases of missing patient’s residence data (1.8%), it was assigned as the location where the ART procedure was performed.
b  Includes infants conceived from ART procedures performed in 2020 and born in 2021 and infants conceived from ART procedures performed in 2021 and born in 2021. ART births exclude births to non-US residents.
c Includes only the number of infants live born in a multiple-birth delivery. For example, if three infants were born in a live-birth delivery, and one of the three infants was stillborn, the total number of live-born infants would be two. However, the two infants still would be counted as triplets.
d US births excludes births to non-US residents. Source: National Center for Health Statistics, Vital statistics data available. Natality public use file and CD-ROM. Hyattsville, MD, National Center for Health Statistics.
e To protect confidentiality, cells with values of 1–4 for ART infants and cells with values of 0–9 for all infants are suppressed. Also suppressed are data that can be used to derive suppressed cell values. These values are included in the totals.
f Estimates based on N <20 in the denominator are suppressed because such rates are considered unstable.
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