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Fact Sheet

April 30, 2004  

MMWR Surveillance Summary
Assisted Reproductive Technology—United States, 2001

The Assisted Reproductive Technology (ART) Surveillance – U.S., 2001 presents the most current information on ART use, number of infants and multiple births resulting from ART by the patient’s state of residence. This is the second ART report to present data on ART by women’s state of residence. The first report included data on ART procedures performed in 2000 and was published in August of 2003. This report also includes the singleton live birth rates because they are an important measure of ART success and singleton births have a much lower risk than multiple-infant births for adverse infant health outcomes, including prematurity, low birth weight, disability and death.

CDC contracts with the Society of Assisted Reproductive Technology (SART) to obtain data from fertility medical centers located in the United States. CDC has compiled data related to ART procedures since 1997 as mandated by the Fertility Clinic Success Rate and Certification Act (Public Law 102-493, October 24, 1992.)


  • Nationwide, more than 107,000 assisted reproductive technology (ART) procedures were performed in the United States in 2001. ART refers to infertility treatments in which an egg and sperm are handled in the laboratory (i.e., in vitro fertilization and related procedures).
  • Throughout the United States, 421 medical centers performed ART in 2001. Of these, 384 (91 percent) reported data to the Centers for Disease Control and Prevention (CDC), which monitors clinic success rates.
  • Approximately 1 percent of the U.S. infants born in 2001 were conceived through ART.
  • In 2001, ART procedures resulted in 29,344 live births and 40,687 infants. More than half (54 percent) of the infants born as a result of ART were born in a multiple-birth delivery.
  • In addition to presenting live-birth rates as a measure of ART success, this report includes success rates for singleton live births (i.e., pregnancies that resulted in the live birth of one child). Singleton live births have a much lower risk than multiple-infant births for adverse infant health outcomes, including prematurity, low birth weight, disability, and death. The singleton live birth rate for 2001 was 21 percent.
  • ART success rates depend on a variety of patient and treatment factors including age, infertility diagnosis, and type of ART procedure.

State information

  • Six states account for almost half of the more than 107,000 ART procedures performed in 2001. California, New York, Massachusetts, Illinois, New Jersey, and Texas had a total of 53,166 ART procedures. These states also had the highest number of ART-associated live-birth deliveries and multiple-birth deliveries.
  • The ratio of number of ART procedures per million population ranged from 74 in Idaho to 1,273 in Massachusetts, with a national average of 371 ART procedure started per million persons.

Multiple births

  • More than half of all infants born through ART in 2001 were multiple births: twins, triplets, or more. This compares with a national multiple birth rate of 3 percent in the general population without ART.
  • Multiple births are associated with risks for both mothers and infants, including cesarean section and hemorrhage for the mother and pre-term delivery, low birth weight, disability and death for the infants.
  • The risk for multiple births was higher for women who had ART procedures using freshly fertilized embryos from their own or donor eggs compared with ART procedures using thawed embryos.
  • Among women who used their own eggs, multiple births were more common among women younger than 35 years of age.
  • The multiple-birth risk increased with the number of embryos transferred during ART, from one to five or more.
  • The availability of embryos for use in ART procedures (an indicator of embryo quality) was also a strong predictor of multiple-birth risk independent of number of embryos transferred.

For More Information

  • “Assisted Reproductive Technology Surveillance—United States, 2001” appears as an MMWR Surveillance Summary and is available at

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This page last updated April 30, 2004

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