Parents who started assisted reproductive technologies (ART) treatments in 2021 gave birth to 97,128 babies, the vast majority of whom were conceived via in vitro fertilization. That’s nearly enough babies to fill Texas’ Cotton Bowl Stadium.
From 2012 to 2021, the number of ART processes started more than doubled, and the number of infants born using these methods increased by 49%. One out of every 42 babies born in the US in 2021 was conceived using these treatments.
What is IVF?
In vitro fertilization (IVF) is the most common alternative method for people who want to have children but are unable to conceive. IVF accounts for over 99% of assisted reproductive technology procedures, according to the Department of Health and Human Services (HHS).
How does the IVF process work?
During an IVF cycle, women and other people who produce female sex cells have their eggs surgically removed. The eggs are combined with sperm in a lab (usually in a test tube or Petri dish). The resulting fertilized embryos are then either transferred into a patient’s uterus or frozen for possible future use. In 2021, about four out of five ART cycles used frozen embryos.
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Fertilized embryos may be transferred either to the patient who provided the egg or to a gestational surrogate, a woman who has arranged to carry an embryo created from someone else’s egg. Surrogate involvement was higher among older patients; 2.9% of ART procedures for patients under 35 used a surrogate, compared with 9.0% for patients over 40.
Women who are unable to provide eggs themselves may also use donated eggs or embryos. This is most common for women over the age of 40, 21.8% of whom opted for this.
Cycles don’t always start with having eggs surgically removed; sometimes, the first step is starting medication to enhance egg production.
What are the most common reasons for using IVF?
Patients pursuing IVF or other ART procedures, including the 40.9% who plan on freezing their eggs, may need help conceiving for any of a variety of reasons. According to the Centers for Disease Control and Prevention (CDC)[1], 27.8% of patients sought ART in part because of male infertility, including a low sperm count or issues with sperm function. This can be impacted by age and other health factors.
Some 26.9% reported low egg counts, which can also be either age-related or a result of genetic or medical causes, while 14.3% reported ovarian complications such as polycystic ovary syndrome (also called PCOS) and 10.4% had damaged or blocked fallopian tubes. Another 16.6% had eggs removed in part so that genetic testing could be done before embryo transfer in cases with heightened risk of passing along genetic abnormalities.
The percentages add up to more than 100 because these categories are not mutually exclusive; couples deciding to pursue IVF may be dealing with multiple complicating factors.
How many people try IVF?
In 2021, 238,126 patients started a total of 413,776 IVF or other ART cycles. That marks a 25% increase in cycles from two years prior and a 135% increase from 2012.
How often does IVF work?
Across all ages of patients, 37.3% of ART cycles result in live births, though success rates vary depending on a host of factors, including age and the reason for pursuing IVF.
Women under the age of 35 using their own eggs delivered live infants 53.7% of the time they had a successful egg retrieval. Rates decreased at higher ages: for 35- to 37-year-old women, ART led to a birth 39.7% of the time, dropping to 26.4% for 38- to 40-year-olds. Women over the age of 40 gave birth 9.4% of the time.
Patients can run into difficulty at different parts of the process. In 2021, 8.4% of egg retrievals were unsuccessful in the first place — more in the case of older patients — and for many patients, multiple egg retrievals are necessary. Even after a successful retrieval, there are no guarantees of either pregnancy or delivery.
Less than half of all embryo transfers resulted in live births. For women 40 and younger using their own eggs, the success rate after embryo transfer was between 40% and 50%; for women over 40, it was 24.4%. For patients of all ages using donor eggs or embryos, success rates ranged from 42.3% to 53.5% depending on the circumstances of the transferred embryo.
For patients using donor eggs, success rates vary from 42.3% to 53.5% depending on the type of egg or embryo being transferred.
Are there health risks associated with IVF?
HHS research indicates that risks associated with IVF are related to the higher likelihoods of having twins or other multiples. Babies conceived via IVF are more likely to be born early and at low birthweights, mostly a result of the fact that 12.5% of infants born using IVF are multiples, compared to 3.2% overall.
Multiple births are more frequent after IVF because embryo transfers often include more than one embryo in order to increase the probability of a successful pregnancy. (As a result, most multiples born through IVF are fraternal.)
Where is IVF most common?
In 2021, IVF was most common in states in the Northeast including Massachusetts (5.4% of babies conceived via IVF), New Jersey (5.0%), Connecticut (4.4%), and New York (4.1%). Washington, DC, has a higher rate than any state, at 5.8%.
Less than one percent of infants born in 2021 in Puerto Rico (0.4%), Alabama (0.6%), Arkansas (0.7%), Mississippi (0.8%), and New Mexico (0.9%) were conceived via IVF.
Legal challenges to IVF
In some states, fetal personhood legislation put in place to restrict abortion access may pose legal threats to IVF. A February 2024 decision in Alabama’s Supreme Court deemed that frozen embryos created via IVF could be considered children under state law, causing some clinics to pause IVF treatments. State lawmakers quickly enacted legislation to protect providers.
In January 2024, Senator and IVF parent Tammy Duckworth of Illinois introduced a federal bill to protect access to IVF. The Senate has not voted on the bill.
How much does IVF cost?
A full cycle of IVF can involve multiple procedures, each with their own costs. HHS reports that a single cycle can range between $15,000 and $20,000 — and that the average number of cycles before a viable pregnancy is 2.5.
Private health insurance often does not cover IVF treatment, and Medicaid coverage for fertility services is dependent by state, so much or all of this cost can be out-of-pocket.
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[1] The CDC takes two years to report data on assisted reproductive technology cycles because clinics report information on pregnancy and birth outcomes over time.
