What are the 2019 Fertility Statistics I Need to Know About?

fertility statistics
What’s the current state of fertility in America? Read on.

Fertility is a growing concern for Americans. As many as one in eight couples reportedly struggle to conceive, and a full third of Americans have either sought fertility treatment themselves or know someone who has.

But there is some good news to be found, with more folks turning to the medical community for help and the number of babies conceived with fertility treatment on the rise.

The truth about fertility statistics comes down to the numbers. So what are those numbers? Let’s dig in.

Fertility factors

Fertility rates have hit a record low in the United States. The latest US government fertility statistics come from 2018, and they estimate there were 59 births year per 1,000 women of childbearing age (defined by the CDC as women between ages 15 and 44).

The CDC claims this the lowest US birth rate in 32 years (and the fourth year in a row of declining births after a spike in 2014). However, researchers say this is actually because more folks are waiting longer to have babies, not necessarily only due to fertility issues.

Female Age Percent change in birth rate (2017-2018)
< 19 Down 7%
20-24 Down 4%
25-29 Down 3%
30-34 Down 1%
35-39 Up 1%
40-44 Up 2%
45-49Up 3%

(Data via the Centers for Disease Control, here.)

The fertility journey is one that can be bumpy, and if you’re nodding your head at that notion, you’re not alone:

33% of Americans have turned to fertility treatments or know someone who has.

  • 12% of women experience difficulties becoming pregnant or carrying a child to term.
  • 1 in 8 couples in America encounter fertility hurdles.
  • 15% of all couples are unable to conceive after a year of unprotected sex.
  • 10% of all couples are unable to conceive after two years of unprotected sex.
  • 33% of Americans have turned to fertility treatments or know someone who has.

(Data via the Centers for Disease Control, here; the U.S. Department of Health and Human Services, here; the National Institutes of Health, here; and the Pew Research Center, here.)

Infertility causes stats

All bodies are different. So it’s probably no big surprise that fertility causes are different from woman-to-woman…and man-to-man, for that matter.

  • 25% of women encounter more than one cause for infertility, according to the American Pregnancy Association.

(Data via the American Pregnancy Association, here)

Age

If you feel like that biological clock is tick, tick, ticking, you’re probably asking what your birthday really means when it comes to fertility.

  • 1 in 4 women get pregnant during any single menstrual cycle during their 20s and early 30s.
  • 1 in 10 women get pregnant per menstrual cycle in their 40s.
  • A 25-year-old woman who has been trying to conceive for three months has an 18% chance of getting pregnant in their next menstrual cycle
  • A 40-year-old woman who has been trying to conceive for three months has a 7% chance.
  • After one year of trying, 25-year-old women have a 10% chance of getting pregnant in their next cycle.
  • After one year of trying, 40-year-old women have a 3% chance of getting pregnant in their next cycle.
  • Women younger than 35 are advised to seek help after a year of trying to conceive.
  • Women 35 and older are advised to seek help after 6 months of trying to conceive.

(Data via the American College of Obstetricians and Gynecologists, here; the National Institutes of Health, here; PLOS One, here; and the Centers for Disease Control, here. )

Age matters when it comes to starting treatment too. Take IVF rates, for example—researchers at the University of New South Wales in Australia estimate:

  • 2 out of 3 women who start IVF before age 35 will take home a baby within three IVF cycles.
  • Women under 30 have a 44% chance of a live birth in their first IVF cycle.
  • Women under 30 have a live-birth rate of between 69% and 91% after six cycles.
  • Women aged 40-44 have an 11% chance of a live birth in their first IVF cycle.
  • Women aged 40-44 have a live-birth rate of between 21-34% after six cycles.

(Data via The Medical Journal of Australia, here, and the University of New South Wales, here.)

Male vs. female factor

Sure, women carry the babies in this world, but if you’re trying to conceive with no success, experts suggest both the male and female partners visit a specialist to find out what’s going on.

9% of men of reproductive age experience fertility issues.

They estimate one third of all fertility issues comes down to the female partner’s reproductive health, one third to the male partner’s reproductive health, and the third is a mix of both partners’ reproductive systems. How common is this? Take this data from the National Institutes of Health:

  • 9% of men of reproductive age experience fertility issues.
  • 11% of women in their childbearing years report fertility concerns.
  • In approximately 40 percent of infertile couples, the male partner is either the sole cause or a contributing cause of infertility.

(Data via the National Institutes of Health, here and here, and the American Society for Reproductive Medicine, here.)

Egg quantity/quality

When you consider most women are born with nearly 2 million eggs, unfortunately, the chances that some of them won’t be winners are pretty decent.

  • 60% of fetuses in first trimester miscarriages are considered “chromosomally abnormal.”

Not to freak you out, but the number of eggs with potential chromosomal abnormalities could increase with age. A mom-to-be’s risk of having a child with a chromosomal abnormality is:

Age Risk of having a child with a chromosomal abnormality
20 1 in 526
30 1 in 384
35 1 in 192
40 1 in 66
45 1 in 21

(Data via the University of New South Wales, here.)

Luckily, there have been tons of advancements in Pre-implantation Genetic Screening (PGS)—so if you’re undergoing IVF, you may be able to circumvent any potential chromosomal abnormalities within the embryo you choose to transfer. As we age, the number of overall eggs decreases too. On average, ACOG estimates women have:

Life stage/age Number of eggs
Birth 1-2 million
Puberty 300,000 – 500,000
37 years old 25,000
51 years old 1,000

(Data via the American College of Obstetricians and Gynecologists, here.)

PCOS

1 in 10 women of childbearing age have PCOS.

PCOS is short for polycystic ovarian syndrome, and it can send a woman’s hormones into a tailspin, affecting the monthly release of eggs needed to get pregnant. That lack of an egg release is called anovulation, and it’s one of the most common—but also most treatable—reasons for fertility struggles in women. Here’s what the US Department of Health and Human Services has to say:

  • 1 in 10 women of childbearing age have PCOS.
  • 30% of couples seeking fertility treatment are diagnosed with anovulation.
  • 90% of anovulation cases are caused by PCOS.

(Data via the US Dep’t of Health & Human Services, here, and Frontiers in Bioscience 6, here.)

Endometriosis

Ever heard of the endometrium? It’s what doctors call the lining of your uterus. If you’re thinking endometrium and endometriosis sound pretty similar, you can probably guess where this is going. This issue with the lining of the uterus is often linked to fertility struggles, according to the folks at the National Institutes of Health:

  • 1 in 10 women are affected by endometriosis during their reproductive years.
  • 30% to 50% of women with endometriosis may experience infertility.

(Data via the American College of Obstetricians and Gynecologists, here.)

Variocele

If an enlarged vein in the testicle sounds painful, imagine what it can do to babymaking. The doctors call this varicocele, and it accounts for a significant number of fertility issues in men.

  • 25% to 35% of men with primary infertility problems have varicocele.
  • 50% to 80% of men with secondary infertility issues have varicocele.

(Data via the Asian Journal of Andrology, here.)

Lack of sperm

It takes sperm to make a baby, so what happens when there is none? It’s called azoospermia, and it is a major factor when it comes to male infertility.

  • 10% to 15% of men who are infertile suffer from a lack of sperm.
  • 1% of all men suffer from azoospermia.

(Data via the National Institutes of Health, here, and Clinics, here.)

Other causes

Not seeing anything familiar? There are some other factors out there that could be causing you to see just one pink line on that pregnancy test each month.

  • As much as 13% of female infertility is caused by cigarette smoking.
  • 12% of fertility concerns are related to a woman weighing either too much or too little.
  • 8.9% to 68.7% of men with infertility report a lack of sexual desire and lack of sexual satisfaction as types of sexual dysfunction.

(Data via the American Society for Reproductive Medicine, here, and Nature Reviews Urology, here.)

Fertility treatment statistics

More women than ever are turning to the medical community for help having a baby. As much as 85% to 90% are treated with conventional medical therapies such as medication or surgery. Take a look at the percentage of women of reproductive age who’ve sought medical help with fertility, broken down by type:

Year Fertility advice Medical help to prevent miscarriage Tests on woman or man Ovulation drugs Artificial insemination
2002 6.1% 5.5% 4.8% 3.8% 1.1%
2006-2010 6.5% 4.9% 5.1% 4% 1.2%
2011-2015 6.3% 5.4% 5.2% 4.2% 1.4%

(Data via the American Society for Reproductive Medicine, here, and the Centers for Disease Control, here.)

IUI

Need a lingo guide? IUI is short for intrauterine insemination. This is the process where a doctor takes a male partner’s sperm and inserts it into the uterus. It’s one of the least invasive treatments out there, and it can be pretty successful in certain situations.

  • 25.5% of couples who undergo IUI become pregnant—the number of cycles required varies.
  • Couples undergoing IUI do an average of 2.1 cycles.
  • 90% of IUI pregnancies occur in the first three cycles of IUI.
  • The pregnancy rate for IUI with donor sperm is 18.1% per cycle.
  • The pregnancy rate for IUI using a partner’s sperm is 9.3% per cycle.
  • Women with a BMI of 25 or more have an IUI pregnancy rate of 12.1% per cycle.
  • Women with a BMI below 25 have an IUI pregnancy rate of 8.9%.

(Data via the Journal of Reproductive Infertility, here.)

IVF

In vitro fertilization (or IVF) gets another cool acronym: ART, or assisted reproductive technology. By the CDC’s definition, ART is any fertility treatment in which either eggs or embryos are handled. So what happens if you are undergoing IVF, or another form of ART?

The average change of taking home a baby with each IVF cycle is 30%.

  • 1.7% of all babies in the U.S. have been born thanks to ART.
  • Approximately 284,385 ART cycles happen each year.
  • Approximately 68,908 live births happen every year thanks to ART.
  • More than 1 million babies have been born via IVF in the US (and that’s just as of 2014!).
  • 33% of moms undergoing IVF get pregnant during their first IVF cycle.
  • 54-77% of women undergoing IVF get pregnant by the eighth cycle.
  • The average chance of taking home a baby with each IVF cycle is 30%.

(Data via the Centers for Disease Control, here; the American Society for Reproductive Medicine, here; The Medical Journal of Australia, here; the University of New South Wales, here; and the Society for Assisted Reproductive Technology, here.)

Surrogacy

Gestational carrier” sounds a bit wordy, but what it boils down to is a surrogate who volunteers to carry a baby for someone (or a couple). Sometimes money changes hands; sometimes it doesn’t. But this can be an alternative for many folks, especially gay men who want to become dads and women who are having difficulty conceiving. Here’s what the CDC has to say:

  • 2% of all assisted reproductive technologies involve a gestational carrier.
  • 16% of couples turning to a gestational carrier in the US are not American themselves.
  • 53.4% of gestational carriers give birth to multiples.

(Data via the Centers for Disease Control, here.)

Egg donation

What’s a mom-to-be to do when her doctor says her eggs may not be able to work come conception time? Egg donation is a growing option, with thousands of moms turning to it every year.

Approximately 3,452 women use frozen donor eggs each year.

  • Approximately 3,324 women use fresh donor eggs each year.
  • Approximately 3,452 women use frozen donor eggs each year.
  • If you use a fresh donor egg in the US, there’s a 40.3% chance per IVF cycle start that the fertility treatment will result in a singleton birth.
  • If you use a frozen donor egg in the US, there’s a 33.3% chance per IVF cycle start that the fertility treatment will result in a singleton birth.
  • 72.7% of egg donors would be willing to have contact with the child down the line.

(Data via the Society for Assisted Reproductive Technology, here, and the Human Reproduction Journal, here.)

Sperm donation

Eggs aren’t the only half of the genetic equation that can come from a friend or a stranger. Donated sperm can be purchased from a sperm bank and used in IUI or IVF.

  • 27% of sperm donors donate to more than one bank.
  • 48% of sperm donors say they want to help others.
  • 85.7% of sperm donors would be willing to have contact with the child down the line.

(Data via the Human Reproduction Journal, here.)

Embryo donation

Sometimes it takes a little bit of magic from two parties to help make a baby. The words for this? Embryo donation. Typically donated by people who have frozen their embryos but have decided their own baby-making journey is over, this option results in hundreds of babies each year.

  • Approximately 1,877 women use donated embryos each year.
  • If you use a donated embryo in the U.S., there’s a 34.7% chance per IVF cycle start that the fertility treatment will result in a singleton birth.

(Data via the Society for Assisted Reproductive Technology, here.)

Costs + coverage

Making a baby gets a bit more costly when you have to turn to a doctor for help—and 0.07% of all of US health care costs are fertility-related.

(Data via the American Society for Reproductive Medicine, here.)

Treatment costs

How much should you be squirreling away for your fertility treatments? Well, that depends on just what you need, but researchers offered up these guidelines in 2010—and things have only gone up from there:

Fertility treatment Median per-person costs
Medications $1,182
IVF (mother’s own egg) $24,373
IVF (donor egg) $38,015

(Data via the American Society for Reproductive Medicine, here.)

Insurance coverage and state mandates

You’ve heard the phrase “location, location, location”? When it comes to getting insurance coverage for fertility treatment, location is key.

  • 16 states require private insurers to provide some form of fertility coverage.
  • Transferring three or more embryos during one ART cycle is more common in the states without a coverage mandate than in the state with a mandate.

(Data via the National Conference of State Legislatures, here, and the Centers for Disease Control, here.)

Company benefits

If you’ve got employer-sponsored health insurance, consider yourself lucky. Fertility coverage is not mandated in most states, and rising costs have resulted in fewer employers offering coverage.

24% of employers offered IVF coverage in 2018, down from 26% in 2014.

  • 10 states require employers provide health insurance coverage for IVF.
  • 6 states require employers provide health insurance coverage for fertility preservation (including egg freezing).
  • 56% of employers with 500 or more employees cover some type of infertility coverage.
  • 24% of employers offered IVF coverage in 2018 (down from 26% in 2014).
  • 3% of employers offer egg freezing coverage for non-medical reasons.

(Data via the American Society for Reproductive Medicine, here; Mercer, here; and the Society for Human Resource Management, here.)

So, what’s the future for fertility treatment?

Gestational carriers are on the rise

They’re not just for celebrities anymore! Between 1999 and 2013 (the most recent year for which data is available), the CDC saw the number of gestational carrier cycles more than double, and it continues to grow.

(Data via the Centers for Disease Control, here.)

Kids conceived via donors want more information

  • Since its creation in 2000, the Donor Sibling Registry has connected thousands of kids to their biological siblings.
  • 82% of donor-conceived offspring would like to make contact with their donor one day.

(Data via the Donor Sibling Registry, here, and the Human Reproduction Journal, here.)

Multiples are multiplying

  • The number of multiples nearly doubled between 1915 (the first year records of this kind were kept) and 2014, the most recent year for which data is available.
  • More than ⅓ of twins and more than ¾ of triplets or higher order multiples result from fertility treatments.

(Data via the Pew Research Center, here.)

Egg freezing is getting easier

  • In 2017, 3% of US employers surveyed by the Society for Human Resource Management said they offer coverage for egg freezing that wasn’t medically necessary, compared to 0% just three years earlier.

(Data via the Society for Human Resource Management, here.)

Fertility coverage carries weight

  • Turnover at companies with fertility coverage was 5% less in 2016, compared to those that don’t offer some sort of benefit.

(Data via Mercer, here.)

Moms are getting older

No matter where they are or what they look like, the average age of women first having babies is on the rise:

  • In 2017, birth rates dropped 12% in rural areas, 16% in small or medium metro areas, and 18% in large metro counties areas.
  • That same year, the mean mother age at the time of their first birth rose by 1.3 years (rural), 1.5 years (small or medium metro), and 1.8 years (large metro).

(Data via the Centers for Disease Control, here.)

Bottom line

Trying to conceive can be lonely, especially when things aren’t going quite the way a woman or couple planned. But the numbers don’t lie: Not only are men and women not alone on their fertility journeys, but help really is out there.

Jeanne Sager

Jeanne Sager is a writer and photographer from upstate New York. She's strung words together for The New York Times, The Atlantic, The Washington Post, and more.

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