State-Specific Assisted Reproductive Technology Surveillance, United States: 2020 Data Brief

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TABLE 4. Number, percentage, and proportion of multiple births, twins, and triplets and higher-order infants born with use of assisted reproductive technology procedures in 2020, 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, and triplets and higher-order infants born with use of assisted reproductive technology procedures in 2020, 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 residence* Multiple-birth infants among ART infants†§ Multiple births among all infants Proportion of ART multiples among all multiples Twin infants among ART infants†§ Twin infants among all infants Proportion of ART twins among all twins Triplets and higher order among ART infants†§ Triplets and higher  order among all infants Proportion of ART triplets and higher order among all triplets+
No. (%) No. (%) (%) No. (%) No. (%) (%) No. (%) No. (%) (%)
Alabama 80 20.4 2,174 3.8 (3.7) 80 20.4 2,097 3.6 (3.8) 0 0.0 77 0.1 (0)
Alaska 12 19.4 294 3.1 (4.1) 12 19.4 ** ** (**) 0 0.0 ** ** (**)
Arizona 266 22.1 2,292 3.0 (11.6) 260 21.6 2,238 2.9 (11.6) 6 0.5 54 0.1 (11.1)
Arkansas 49 20.9 1,153 3.3 (4.2) ** ** 1,125 3.2 (**) ** ** 28 0.1 (**)
California 1,256 12.7 12,236 2.9 (10.3) 1,227 12.4 11,975 2.8 (10.2) 29 0.3 261 0.1 (11.1)
Colorado 186 13.7 1,849 3.0 (10.1) 177 13.0 1,810 2.9 (9.8) 9 0.7 39 0.1 (23.1)
Connecticut 122 9.2 1,180 3.5 (10.3) 122 9.2 1,156 3.5 (10.6) 0 0.0 24 0.1 (0)
Delaware 8 3.0 324 3.1 (2.5) 8 3.0 ** ** (**) 0 0.0 ** ** (**)
District of Columbia 31 6.5 295 3.3 (10.5) ** ** 280 3.2 (**) ** ** †† 0.2 (**††)
Florida 434 13.6 6,427 3.1 (6.8) 428 13.4 6,276 3.0 (6.8) 6 0.2 151 0.1 (4)
Georgia 250 13.7 4,136 3.4 (6.0) 238 13.0 4,044 3.3 (5.9) 12 0.7 92 0.1 (13)
Hawaii 84 21.1 445 2.8 (18.9) ** ** ** ** (**) ** ** ** ** (**)
Idaho 57 20.3 666 3.1 (8.6) ** ** 651 3.0 (**) ** ** †† 0.1 (**††)
Illinois 514 12.1 4,357 3.3 (11.8) 502 11.8 4,243 3.2 (11.8) 12 0.3 114 0.1 (10.5)
Indiana 178 19.2 2,546 3.2 (7.0) 172 18.6 2,473 3.1 (7.0) 6 0.6 73 0.1 (8.2)
Iowa 64 10.5 1,313 3.6 (4.9) 64 10.5 1,282 3.5 (5.0) 0 0.0 31 0.1 (0)
Kansas 65 13.7 1,082 3.1 (6.0) ** ** 1,049 3.1 (**) ** ** 33 0.1 (**)
Kentucky 79 16.3 1,624 3.1 (4.9) ** ** 1,605 3.1 (**) ** ** †† 0.0 (**††)
Louisiana 48 9.0 1,953 3.4 (2.5) 42 7.8 1,902 3.3 (2.2) 6 1.1 51 0.1 (11.8)
Maine 39 17.3 383 3.3 (10.2) ** ** ** ** (**) ** ** ** ** (**)
Maryland 184 8.8 2,118 3.1 (8.7) ** ** 2,064 3.0 (**) ** ** 54 0.1 (**)
Massachusetts 379 10.1 2,122 3.2 (17.9) ** ** 2,072 3.1 (**) ** ** 50 0.1 (**)
Michigan 411 22.6 3,734 3.6 (11.0) 398 21.9 3,624 3.5 (11.0) 13 0.7 110 0.1 (11.8)
Minnesota 261 18.7 2,181 3.4 (12.0) 249 17.8 2,098 3.3 (11.9) 12 0.9 83 0.1 (14.5)
Mississippi 22 9.1 1,184 3.3 (1.9) 22 9.1 1,160 3.3 (1.9) 0 0.0 24 0.1 (0)
Missouri 160 17.0 2,332 3.4 (6.9) 148 15.7 2,280 3.3 (6.5) 12 1.3 52 0.1 (23.1)
Montana 16 11.0 330 3.1 (4.8) 16 11.0 320 3.0 (5.0) 0 0.0 †† 0.1 (0.0††)
Nebraska 74 19.4 874 3.6 (8.5) ** ** 825 3.4 (**) ** ** 49 0.2 (**)
Nevada 76 13.4 1,020 3.0 (7.5) 70 12.3 1,001 3.0 (7.0) 6 1.1 †† 0.1 (††)
New Hampshire 32 8.8 365 3.1 (8.8) 32 8.8 ** ** (**) 0 ** ** ** (**)
New Jersey 367 8.3 3,210 3.3 (11.4) 355 8.1 3,105 3.2 (11.4) 12 0.3 105 0.1 (11.4)
New Mexico 20 11.2 520 2.4 (3.8) 20 11.2 508 2.3 (3.9) 0 0.0 †† 0.1 (††)
New York 817 10.9 6,957 3.3 (11.7) 787 10.5 6,817 3.3 (11.5) 30 0.4 140 0.1 (21.4)
North Carolina 204 10.8 3,937 3.4 (5.2) ** ** 3,820 3.3 (**) ** ** 117 0.1 (**)
North Dakota 22 18.2 319 3.2 (6.9) 22 18.2 308 3.1 (7.1) 0 0.0 †† 0.1 (††)
Ohio 218 11.5 4,295 3.3 (5.1) 209 11.0 4,177 3.2 (5.0) 9 0.5 118 0.1 (7.6)
Oklahoma 99 22.8 1,541 3.2 (6.4) ** ** 1,505 3.2 (**) ** ** 36 0.1 (**)
Oregon 144 19.5 1,268 3.2 (11.4) 138 18.7 1,247 3.1 (11.1) 6 0.8 21 0.1 (28.6)
Pennsylvania 223 8.7 4,176 3.2 (5.3) ** ** 4,088 3.1 (**) ** ** 88 0.1 (**)
Puerto Rico 32 43.2 437 2.3 (7.3) 32 43.2 425 2.2 (7.5) 0 0.0 †† 0.1 (††)
Rhode Island 22 8.4 304 3.0 (7.2) 22 8.4 ** ** (**) 0 0.0 ** ** (**)
South Carolina 91 12.3 1,954 3.5 (4.7) 82 11.1 1,914 3.4 (4.3) 9 1.2 40 0.1 (22.5)
South Dakota 28 24.8 348 3.2 (8.0) 28 24.8 ** ** (**) 0 0.0 ** ** (**)
Tennessee 94 11.8 2,569 3.3 (3.7) 94 11.8 2,495 3.2 (3.8) 0 0.0 74 0.1 (0)
Texas 781 12.5 10,965 3.0 (7.1) 763 12.2 10,697 2.9 (7.1) 18 0.3 268 0.1 (6.7)
Utah 177 18.1 1,516 3.3 (11.7) 162 16.5 1,447 3.2 (11.2) 15 1.5 69 0.2 (21.7)
Vermont 24 18.0 153 3.0 (15.7) 24 18.0 ** ** (**) 0 0.0 ** ** (**)
Virginia 212 9.9 3,133 3.3 (6.8) ** ** 3,049 3.2 (**) ** ** 84 0.1 (**)
Washington 206 10.9 2,448 2.9 (8.4) 206 10.9 2,387 2.9 (8.6) 0 0.0 61 0.1 (0)
West Virginia 16 11.0 528 3.0 (3.0) 16 11.0 ** ** (**) 0 0.0 ** ** (**)
Wisconsin 137 15.2 1,990 3.3 (6.9) 137 15.2 1,943 3.2 (7.1) 0 0.0 47 0.1 (0)
Wyoming 13 15.7 192 3.1 (6.8) 13 15.7 ** ** (**) 0 0.0 ** ** (**)
Total 9,384 12.6 115,749 3.2 (8.1) 9,114 12.3 112,862 3.1 (8.1) 270 0.4 2,887 0.1 (9.4)
ART = assisted reproductive technology.
*In cases of missing patient’s residence data (2.3%), it was assigned as the location where the ART procedure was performed.
†ART totals include infants conceived from ART procedures performed in 2019 and born in 2020 and infants conceived from ART procedures performed in 2020 and born in 2020. Total ART births exclude births to non-US residents.
§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.
US births exclude 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.
**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.
††Estimates based on N <20 in the denominator are suppressed because such rates are considered unstable.
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