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 area of residence at time of treatment — United States and Puerto Rico, 2018.
| Patient’s area of residence* | Multiple-birth infants among ART infants†,§ |
Multiple births among all infants¶ |
Proportion of ART multiple births among all multiple births |
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 |
105 (27.0) |
2,106 (3.6) |
5.0 |
96 (24.7) |
2,015 (3.5) |
4.8 |
9 (2.3) |
91 (0.2) |
9.9 |
| Alaska |
20 (26.3) |
345 (3.4) |
5.8 |
20 (26.3) |
330 (3.3) |
6.1 |
0 (0.0) |
15 (0.1) |
—†† |
| Arizona |
431 (32.4) |
2,641 (3.3) |
16.3 |
412 (31.0) |
2,545 (3.2) |
16.2 |
19 (1.4) |
96 (0.1) |
19.8 |
| Arkansas |
97 (39.4) |
1,164 (3.1) |
8.3 |
88 (35.8) |
1,124 (3.0) |
7.8 |
9 (3.7) |
40 (0.1) |
22.5 |
| California |
1,970 (19.7) |
14,221 (3.1) |
13.9 |
1,928 (19.2) |
13,851 (3.0) |
13.9 |
42 (0.4) |
370 (0.1) |
11.4 |
| Colorado |
321 (22.6) |
2,018 (3.2) |
15.9 |
321 (22.6) |
1,990 (3.2) |
16.1 |
0 (0.0) |
28 (0.0) |
0.0 |
| Connecticut |
293 (20.5) |
1,296 (3.7) |
22.6 |
287 (20.1) |
1,265 (3.6) |
22.7 |
6 (0.4) |
31 (0.1) |
19.4 |
| Delaware |
14 (6.1) |
298 (2.8) |
4.7 |
14 (6.1) |
—** |
—** |
0 (0.0) |
—** |
—**,†† |
| District of Columbia |
48 (11.2) |
325 (3.5) |
14.8 |
48 (11.2) |
314 (3.4) |
15.3 |
0 (0.0) |
11 (0.1) |
—†† |
| Florida |
786 (24.3) |
7,062 (3.2) |
11.1 |
759 (23.5) |
6,906 (3.1) |
11.0 |
27 (0.8) |
156 (0.1) |
17.3 |
| Georgia |
421 (22.8) |
4,394 (3.5) |
9.6 |
415 (22.5) |
4,281 (3.4) |
9.7 |
6 (0.3) |
113 (0.1) |
5.3 |
| Hawaii |
151 (35.5) |
529 (3.1) |
28.5 |
142 (33.4) |
511 (3.0) |
27.8 |
9 (2.1) |
18 (0.1) |
—†† |
| Idaho |
109 (34.9) |
713 (3.3) |
15.3 |
109 (34.9) |
701 (3.3) |
15.5 |
0 (0.0) |
12 (0.1) |
—†† |
| Illinois |
883 (19.7) |
5,254 (3.6) |
16.8 |
862 (19.3) |
5,102 (3.5) |
16.9 |
21 (0.5) |
152 (0.1) |
13.8 |
| Indiana |
233 (28.0) |
2,770 (3.4) |
8.4 |
227 (27.3) |
2,699 (3.3) |
8.4 |
6 (0.7) |
71 (0.1) |
8.5 |
| Iowa |
146 (21.2) |
1,352 (3.6) |
10.8 |
140 (20.3) |
1,320 (3.5) |
10.6 |
6 (0.9) |
32 (0.1) |
18.8 |
| Kansas |
68 (17.0) |
1,164 (3.2) |
5.8 |
68 (17.0) |
1,152 (3.2) |
5.9 |
0 (0.0) |
12 (0.0) |
—†† |
| Kentucky |
164 (30.8) |
1,831 (3.4) |
9.0 |
153 (28.7) |
1,799 (3.3) |
8.5 |
11 (2.1) |
32 (0.1) |
34.4 |
| Louisiana |
109 (20.2) |
2,089 (3.5) |
5.2 |
—** |
2,029 (3.4) |
—** |
—** |
60 (0.1) |
—** |
| Maine |
54 (26.2) |
427 (3.5) |
12.6 |
48 (23.3) |
408 (3.3) |
11.8 |
6 (2.9) |
19 (0.2) |
—†† |
| Maryland |
352 (16.1) |
2,488 (3.5) |
14.1 |
340 (15.5) |
2,397 (3.4) |
14.2 |
12 (0.5) |
91 (0.1) |
13.2 |
| Massachusetts |
547 (15.4) |
2,445 (3.5) |
22.4 |
523 (14.8) |
2,373 (3.4) |
22.0 |
24 (0.7) |
72 (0.1) |
33.3 |
| Michigan |
584 (32.8) |
4,059 (3.7) |
14.4 |
560 (31.5) |
3,950 (3.6) |
14.2 |
24 (1.3) |
109 (0.1) |
22.0 |
| Minnesota |
349 (25.0) |
2,329 (3.5) |
15.0 |
336 (24.1) |
2,270 (3.4) |
14.8 |
13 (0.9) |
59 (0.1) |
22.0 |
| Mississippi |
48 (19.7) |
1,303 (3.5) |
3.7 |
42 (17.2) |
1,251 (3.4) |
3.4 |
6 (2.5) |
52 (0.1) |
11.5 |
| Missouri |
298 (30.8) |
2,658 (3.6) |
11.2 |
285 (29.4) |
2,593 (3.5) |
11.0 |
13 (1.3) |
65 (0.1) |
20.0 |
| Montana |
23 (17.3) |
329 (2.9) |
7.0 |
—** |
—** |
—** |
—** |
—** |
—** |
| Nebraska |
108 (31.1) |
937 (3.7) |
11.5 |
—** |
894 (3.5) |
—** |
—** |
43 (0.2) |
—** |
| Nevada |
146 (25.7) |
1,044 (2.9) |
14.0 |
140 (24.7) |
1,026 (2.9) |
13.6 |
6 (1.1) |
18 (0.1) |
—†† |
| New Hampshire |
110 (25.1) |
416 (3.5) |
26.4 |
110 (25.1) |
416 (3.5) |
26.4 |
0 (0.0) |
0 (0.0) |
—†† |
| New Jersey |
614 (14.5) |
3,556 (3.5) |
17.3 |
599 (14.1) |
3,457 (3.4) |
17.3 |
15 (0.4) |
99 (0.1) |
15.2 |
| New Mexico |
38 (20.4) |
586 (2.5) |
6.5 |
38 (20.4) |
573 (2.5) |
6.6 |
0 (0.0) |
13 (0.1) |
—†† |
| New York |
1,476 (19.1) |
7,994 (3.5) |
18.5 |
1,440 (18.6) |
7,754 (3.4) |
18.6 |
36 (0.5) |
240 (0.1) |
15.0 |
| North Carolina |
419 (22.6) |
4,006 (3.4) |
10.5 |
404 (21.8) |
3,873 (3.3) |
10.4 |
15 (0.8) |
133 (0.1) |
11.3 |
| North Dakota |
43 (32.3) |
346 (3.3) |
12.4 |
43 (32.3) |
—** |
—** |
0 (0.0) |
—** |
—** |
| Ohio |
357 (19.4) |
4,580 (3.4) |
7.8 |
344 (18.7) |
4,431 (3.3) |
7.8 |
13 (0.7) |
149 (0.1) |
8.7 |
| Oklahoma |
122 (31.0) |
1,671 (3.4) |
7.3 |
122 (31.0) |
1,642 (3.3) |
7.4 |
0 (0.0) |
29 (0.1) |
0.0 |
| Oregon |
222 (29.4) |
1,490 (3.5) |
14.9 |
210 (27.8) |
1,464 (3.5) |
14.3 |
12 (1.6) |
26 (0.1) |
46.2 |
| Pennsylvania |
396 (15.6) |
4,474 (3.3) |
8.9 |
374 (14.7) |
4,338 (3.2) |
8.6 |
22 (0.9) |
136 (0.1) |
16.2 |
| Puerto Rico |
38 (45.2) |
447 (2.1) |
8.5 |
38 (45.2) |
—** |
—** |
0 (0.0) |
—** |
—** |
| Rhode Island |
61 (20.3) |
383 (3.6) |
15.9 |
—** |
365 (3.5) |
—** |
—** |
18 (0.2) |
—**,†† |
| South Carolina |
157 (22.7) |
1,884 (3.3) |
8.3 |
157 (22.7) |
1,860 (3.3) |
8.4 |
0 (0.0) |
24 (0.0) |
0.0 |
| South Dakota |
38 (29.5) |
427 (3.6) |
8.9 |
38 (29.5) |
—** |
—** |
0 (0.0) |
—** |
—** |
| Tennessee |
193 (24.3) |
2,709 (3.4) |
7.1 |
181 (22.8) |
2,624 (3.2) |
6.9 |
12 (1.5) |
85 (0.1) |
14.1 |
| Texas |
1,469 (23.8) |
11,960 (3.2) |
12.3 |
1,445 (23.4) |
11,603 (3.1) |
12.5 |
24 (0.4) |
357 (0.1) |
6.7 |
| Utah |
305 (28.0) |
1,629 (3.5) |
18.7 |
299 (27.4) |
1,571 (3.3) |
19.0 |
6 (0.5) |
58 (0.1) |
10.3 |
| Vermont |
29 (24.2) |
183 (3.4) |
15.8 |
29 (24.2) |
—** |
—** |
0 (0.0) |
—** |
—** |
| Virginia |
393 (16.8) |
3,473 (3.5) |
11.3 |
381 (16.3) |
3,368 (3.4) |
11.3 |
12 (0.5) |
105 (0.1) |
11.4 |
| Washington |
325 (18.8) |
2,579 (3.0) |
12.6 |
—** |
2,501 (2.9) |
—** |
—** |
78 (0.1) |
—** |
| West Virginia |
34 (28.1) |
591 (3.2) |
5.8 |
34 (28.1) |
—** |
—** |
0 (0.0) |
—** |
—** |
| Wisconsin |
252 (27.5) |
2,303 (3.6) |
10.9 |
240 (26.2) |
2,236 (3.5) |
10.7 |
12 (1.3) |
67 (0.1) |
17.9 |
| Wyoming |
32 (32.7) |
230 (3.5) |
13.9 |
32 (32.7) |
220 (3.4) |
14.5 |
0 (0.0) |
10 (0.2) |
—†† |
| Total | 16,001 (21.4) | 127,508 (3.3) | 12.5 | 15,532 (20.7) | 123,974 (3.3) | 12.5 | 469 (0.6) | 3,534 (0.1) | 13.3 |
Abbreviation: ART = assisted reproductive technology.
* In cases of missing patient’s residence data (0.3%), 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 2017 and born in 2018 and infants conceived from ART procedures performed in 2018 and born in 2018. Total ART births exclude births to non-U.S. 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.
¶ U.S. births exclude births to non-U.S. 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 on the basis of N <20 in the denominator have been suppressed because such rates are considered unstable.