Section 1: Overview

Although ART clinics are located throughout the United States, generally in or near major cities, the greatest number of clinics is in the eastern United States. Figure 1 shows the locations of the 441 reporting clinics. The fertility clinic section of this report, provides specific information on each of these clinics. The number of clinics, cycles performed, live-birth deliveries, and infants born as a result of ART all have increased steadily since CDC began collecting this information in 1995 (see Section 5). Because in some cases more than one infant is born during a live-birth delivery (e.g., twins), the total number of infants born is greater than the number of live-birth deliveries. CDC estimates that ART accounts for slightly more than 1% of total U.S. births.

Figure 2 shows the types of ART cycles performed in the United States in 2009. For approximately 70% of ART cycles performed in 2009, fresh nondonor eggs or embryos were used. ART cycles that used frozen nondonor embryos were the next most common type, accounting for approximately 18% of the total. In about 12% of cycles, eggs or embryos were donated by another woman. A very small number of cycles (less than 0.1%) involved the evaluation of a new treatment procedure. Cycles in which a new treatment procedure was being evaluated are not included in the total number of cycles reported in the national report or in the individual fertility clinic tables. Thus, data presented in subsequent figures in this report and in the individual fertility clinic tables are based on 146,244 ART cycles.

Figure 3 presents ART cycles performed in the United States in 2009 according to the age of the woman who had the procedure. The average age of women using ART services in 2009 was 36. The largest group of women using ART services were women younger than 35, representing approximately 39% of all ART cycles performed in 2009. Approximately 20% of ART cycles were performed among women aged 35–37, 21% among women aged 38–40, 10% among women aged 41–42, 6% among women aged 43–44, and 5% among women older than 44.

Figure 4 shows that, in 2009, the type of ART cycles varied by the woman’s age. The vast majority (97%) of women younger than 35 used their own eggs, whereas about 3% used donor eggs. In contrast, 36% of women aged 43–44 and 73% of women older than 44 used donor eggs. Across all age groups, more ART cycles using fresh eggs or embryos were performed than cycles using frozen embryos.

The number of ART procedures performed every year varies among fertility clinics in the United States. For Figure 5, clinics were divided equally into four groups (called quartiles) based on the size of the clinic as determined by the number of ART cycles it performed in 2009. The percentage for each quartile by type of ART represents the average percentage of ART cycles that resulted in live births for clinics in that quartile.

In 2009, percentages of ART cycles that resulted in live births using fresh nondonor eggs or embryos were similar for all 441 clinics regardless of the number of cycles performed. However, for fresh donor cycles, the percentage of cycles that resulted in live births increased as the clinic size increased. Among frozen nondonor and frozen donor cycles, the percentage of cycles that resulted in live births varied by clinic size.