TABLE 4. Number, percentage, and proportion of multiple-birth infants, twins, and triplets and higher-order infants born with use of assisted reproductive technology procedures, by female patient’s reporting area of residence* at time of treatment — United States and Puerto Rico, 2016†.
| Patient’s reporting area of residence | Multiple-birth infants among ART infants§ |
Multiple-birth infants among all infants¶ |
Proportion of ART multiple-birth infants among all multiple-birth infants (%) | Twin infants among ART infants§ |
Twin infants among all infants¶ |
Proportion of ART twin infants among all twin infants (%) | Triplets and higher-order infants among ART infants§ |
Triplets and higher-order infants among all infants¶ |
Proportion of ART triplets and higher-order infants among all triplets and higher-order infants (%) |
|---|---|---|---|---|---|---|---|---|---|
| No. (%) | No. (%) | No. (%) | No. (%) | No. (%) | No. (%) | ||||
| Alabama |
189 (42.5) |
2,273 (3.8) |
8.3 |
174 (39.1) |
2,182 (3.7) |
8.0 |
15 (3.4) |
91 (0.2) |
16.5 |
| Alaska |
37 (44.6) |
— (—)** |
—** |
37 (44.6) |
374 (3.3) |
9.9 |
0 (0.0) |
— (—)** |
—** |
| Arizona |
457 (39.6) |
2,656 (3.1) |
17.2 |
429 (37.2) |
2,583 (3.1) |
16.6 |
28 (2.4) |
73 (0.1) |
38.4 |
| Arkansas |
86 (39.1) |
1,120 (2.9) |
7.7 |
86 (39.1) |
1,093 (2.9) |
7.9 |
0 (0.0) |
27 (0.1) |
0.0 |
| California |
2,620 (28.2) |
15,497 (3.2) |
16.9 |
2,535 (27.2) |
15,068 (3.1) |
16.8 |
85 (0.9) |
429 (0.1) |
19.8 |
| Colorado |
394 (32.1) |
2,114 (3.2) |
18.6 |
381 (31.0) |
2,046 (3.1) |
18.6 |
13 (1.1) |
68 (0.1) |
19.1 |
| Connecticut |
486 (34.9) |
1,562 (4.3) |
31.1 |
462 (33.2) |
1,511 (4.2) |
30.6 |
24 (1.7) |
51 (0.1) |
47.1 |
| Delaware |
38 (13.9) |
— (—)** |
—** |
38 (13.9) |
325 (3.0) |
11.7 |
0 (0.0) |
— (—)** |
—**,†† |
| District of Columbia |
57 (16.3) |
— (—)** |
—** |
— (—)** |
388 (3.9) |
—** |
— (—)** |
— (—)** |
—**,†† |
| Florida |
1,057 (34.5) |
7,334 (3.3) |
14.4 |
1,015 (33.1) |
7,162 (3.2) |
14.2 |
42 (1.4) |
172 (0.1) |
24.4 |
| Georgia |
416 (26.5) |
4,423 (3.4) |
9.4 |
404 (25.7) |
4,271 (3.3) |
9.5 |
12 (0.8) |
152 (0.1) |
7.9 |
| Hawaii |
164 (40.3) |
624 (3.5) |
26.3 |
155 (38.1) |
590 (3.3) |
26.3 |
9 (2.2) |
34 (0.2) |
26.5 |
| Idaho |
119 (40.9) |
743 (3.3) |
16.0 |
113 (38.8) |
715 (3.2) |
15.8 |
6 (2.1) |
28 (0.1) |
21.4 |
| Illinois |
1,406 (31.6) |
5,941 (3.8) |
23.7 |
1,357 (30.5) |
5,772 (3.7) |
23.5 |
49 (1.1) |
169 (0.1) |
29.0 |
| Indiana |
319 (37.0) |
2,857 (3.4) |
11.2 |
304 (35.3) |
2,744 (3.3) |
11.1 |
15 (1.7) |
113 (0.1) |
13.3 |
| Iowa |
213 (30.0) |
1,359 (3.4) |
15.7 |
204 (28.7) |
1,310 (3.3) |
15.6 |
9 (1.3) |
49 (0.1) |
18.4 |
| Kansas |
131 (29.9) |
1,148 (3.0) |
11.4 |
125 (28.5) |
1,111 (2.9) |
11.3 |
6 (1.4) |
37 (0.1) |
16.2 |
| Kentucky |
185 (34.5) |
2,013 (3.6) |
9.2 |
170 (31.7) |
1,938 (3.5) |
8.8 |
15 (2.8) |
75 (0.1) |
20.0 |
| Louisiana |
196 (36.4) |
2,249 (3.6) |
8.7 |
190 (35.3) |
2,157 (3.4) |
8.8 |
6 (1.1) |
92 (0.1) |
6.5 |
| Maine |
45 (23.2) |
399 (3.1) |
11.3 |
— (—)** |
384 (3.0) |
—** |
— (—)** |
15 (0.1) |
—**,†† |
| Maryland |
431 (21.2) |
2,551 (3.5) |
16.9 |
414 (20.3) |
2,475 (3.4) |
16.7 |
17 (0.8) |
76 (0.1) |
22.4 |
| Massachusetts |
697 (20.8) |
2,661 (3.7) |
26.2 |
685 (20.4) |
2,571 (3.6) |
26.6 |
12 (0.4) |
90 (0.1) |
13.3 |
| Michigan |
817 (45.9) |
4,375 (3.9) |
18.7 |
790 (44.4) |
4,239 (3.7) |
18.6 |
27 (1.5) |
136 (0.1) |
19.9 |
| Minnesota |
463 (37.4) |
2,453 (3.5) |
18.9 |
454 (36.6) |
2,401 (3.4) |
18.9 |
9 (0.7) |
52 (0.1) |
17.3 |
| Mississippi |
74 (31.6) |
1,267 (3.3) |
5.8 |
— (—)** |
1,231 (3.2) |
—** |
— (—)** |
36 (0.1) |
—** |
| Missouri |
393 (38.3) |
2,687 (3.6) |
14.6 |
375 (36.5) |
2,594 (3.5) |
14.5 |
18 (1.8) |
93 (0.1) |
19.4 |
| Montana |
66 (45.2) |
— (—)** |
—** |
66 (45.2) |
379 (3.1) |
17.4 |
0 (0.0) |
— (—)** |
—**,†† |
| Nebraska |
112 (35.1) |
946 (3.6) |
11.8 |
112 (35.1) |
898 (3.4) |
12.5 |
0 (0.0) |
48 (0.2) |
0.0 |
| Nevada |
200 (33.2) |
1,137 (3.1) |
17.6 |
— (—)** |
1,115 (3.1) |
—** |
— (—)** |
22 (0.1) |
—** |
| New Hampshire |
65 (24.1) |
372 (3.0) |
17.5 |
— (—)** |
351 (2.9) |
—** |
— (—)** |
21 (0.2) |
—** |
| New Jersey |
1,041 (26.0) |
4,006 (3.9) |
26.0 |
1,018 (25.4) |
3,900 (3.8) |
26.1 |
23 (0.6) |
106 (0.1) |
21.7 |
| New Mexico |
39 (39.8) |
657 (2.7) |
5.9 |
— (—)** |
642 (2.6) |
—** |
— (—)** |
15 (0.1) |
—**,†† |
| New York |
1,990 (28.5) |
8,761 (3.7) |
22.7 |
1,927 (27.6) |
8,539 (3.6) |
22.6 |
63 (0.9) |
222 (0.1) |
28.4 |
| North Carolina |
603 (35.9) |
4,249 (3.5) |
14.2 |
576 (34.2) |
4,126 (3.4) |
14.0 |
27 (1.6) |
123 (0.1) |
22.0 |
| North Dakota |
77 (55.0) |
379 (3.3) |
20.3 |
— (—)** |
364 (3.2) |
—** |
— (—)** |
15 (0.1) |
—**,†† |
| Ohio |
795 (40.5) |
5,149 (3.7) |
15.4 |
756 (38.5) |
4,975 (3.6) |
15.2 |
39 (2.0) |
174 (0.1) |
22.4 |
| Oklahoma |
168 (42.2) |
1,678 (3.2) |
10.0 |
159 (39.9) |
1,641 (3.1) |
9.7 |
9 (2.3) |
37 (0.1) |
24.3 |
| Oregon |
249 (38.7) |
1,549 (3.4) |
16.1 |
240 (37.3) |
1,501 (3.3) |
16.0 |
9 (1.4) |
48 (0.1) |
18.8 |
| Pennsylvania |
626 (26.4) |
4,876 (3.5) |
12.8 |
611 (25.7) |
4,766 (3.4) |
12.8 |
15 (0.6) |
110 (0.1) |
13.6 |
| Puerto Rico |
35 (43.2) |
570 (2.0) |
6.1 |
35 (43.2) |
556 (2.0) |
6.3 |
0 (0.0) |
14 (0.0) |
—†† |
| Rhode Island |
69 (30.1) |
409 (3.8) |
16.9 |
— (—)** |
393 (3.6) |
—** |
— (—)** |
16 (0.1) |
—**,†† |
| South Carolina |
314 (43.1) |
2,140 (3.7) |
14.7 |
288 (39.5) |
2,063 (3.6) |
14.0 |
26 (3.6) |
77 (0.1) |
33.8 |
| South Dakota |
74 (50.3) |
450 (3.7) |
16.4 |
62 (42.2) |
429 (3.5) |
14.5 |
12 (8.2) |
21 (0.2) |
57.1 |
| Tennessee |
250 (35.4) |
2,732 (3.4) |
9.2 |
235 (33.2) |
2,641 (3.3) |
8.9 |
15 (2.1) |
91 (0.1) |
16.5 |
| Texas |
2,175 (35.6) |
12,902 (3.2) |
16.9 |
2,124 (34.7) |
12,505 (3.1) |
17.0 |
51 (0.8) |
397 (0.1) |
12.8 |
| Utah |
412 (40.4) |
1,917 (3.8) |
21.5 |
403 (39.5) |
1,863 (3.7) |
21.6 |
9 (0.9) |
54 (0.1) |
16.7 |
| Vermont |
34 (32.1) |
— (—)** |
—** |
— (—)** |
185 (3.2) |
—** |
— (—)** |
— (—)** |
—**,†† |
| Virginia |
568 (27.1) |
3,626 (3.5) |
15.7 |
559 (26.7) |
3,534 (3.4) |
15.8 |
9 (0.4) |
92 (0.1) |
9.8 |
| Washington |
396 (26.2) |
2,713 (3.0) |
14.6 |
375 (24.8) |
2,649 (2.9) |
14.2 |
21 (1.4) |
64 (0.1) |
32.8 |
| West Virginia |
49 (37.7) |
588 (3.1) |
8.3 |
— (—)** |
565 (3.0) |
—** |
— (—)** |
23 (0.1) |
—** |
| Wisconsin |
317 (36.8) |
2,297 (3.4) |
13.8 |
— (—)** |
2,243 (3.4) |
—** |
— (—)** |
54 (0.1) |
—** |
| Wyoming |
19 (31.7) |
— (—)** |
—** |
19 (31.7) |
221 (3.0) |
8.6 |
0 (0.0) |
— (—)** |
—**,†† |
| Total | 22,233 (31.5) | 135,740 (3.4) | 16.4 | 21,455 (30.4) | 132,279 (3.3) | 16.2 | 778 (1.1) | 4,017 (0.1) | 19.4 |
Abbreviation: ART = assisted reproductive technology.
* In cases of missing residency data (0.4%), the patient’s residence was assigned as the location where the ART procedure was performed.
† ART totals include infants conceived from ART procedures performed in 2015 and born in 2016 and infants conceived from ART procedures performed in 2016 and born in 2016. Total ART births exclude births to nonresidents.
§ 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.
¶ U.S. births include births to nonresidents. Source: CDC Wonder [Internet]. Natality public use data 2007–2016. Atlanta, GA: US Department of Health and Human Services, CDC; 2018.
** 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 on the basis of N = <20 in the denominator have been suppressed because such rates are considered unstable.