Use of Fertility Services Among Women Ages 20-49 in the United States: 2022-2023

NCHS Data Brief No. 542, December 2025

PDF Version (323 KB)

Colleen N. Nugent, Ph.D., and Anjani Chandra, Ph.D.

Introduction

The percentage of women ages 25-44 in the United States who had ever used any fertility services, defined as any medical help to get pregnant or to prevent pregnancy loss, decreased between 2006-2010 and 2015-2019 (1). However, estimates of fertility problems remained stable or increased in that time span (2,3). Using the 2022-2023 National Survey of Family Growth (NSFG), this report estimates ever use of specific fertility services among women ages 20-49 in the United States, as well as ever use of any medical help to get pregnant, any medical help to prevent pregnancy loss, and any fertility services overall, by selected socioeconomic characteristics.

Type and specific services

• Among women ages 20-49 in 2022-2023, 13.7% had ever used any fertility services (Figure 1, Table 1).
• Any medical help to get pregnant was used by 10.4% of women ages 20-49, nearly twice the percentage who used any medical help to prevent pregnancy loss (5.8%).
• Among types of medical help to get pregnant, 6.9% of women ages 20-49 had infertility testing on themselves or their partner, 4.5% used ovulation drugs, 2.0% had artificial insemination, 1.7% used surgery or drugs for endometriosis or fibroids, 1.6% used in vitro fertilization (IVF) or other assisted reproductive technology procedures, and 0.6% had tubal surgery.
• Among types of medical help to prevent pregnancy loss, 2.8% of women ages 20-49 used bed rest or activity limitation, 2.2% used drugs to prevent miscarriage, and 2.0% had miscarriage diagnostic testing.

Race and Hispanic origin

• The percentage of women ages 20-49 in 2022-2023 who had ever used any fertility services was higher in Asian non-Hispanic (subsequently, Asian) (16.0%) and White non-Hispanic (subsequently, White) (15.2%) women compared with Black non-Hispanic (subsequently, Black) women (9.5%) (Figure 2, Table 2).
• The observed difference in the use of any fertility services between Hispanic women and women of other non-Hispanic racial groups was not significant.
• Higher percentages of Asian (13.6%) and White (12.4%) women had ever used any medical help to get pregnant compared with Black (7.1%) and Hispanic (7.0%) women.
• The observed difference between Hispanic women and women of other non-Hispanic racial groups for the use of any medical help to prevent pregnancy loss was not significant.

Family income

• Among women ages 20-49 in 2022-2023, the percentage who had ever used any fertility services increased with higher levels of family income, from 9.5% for women with family incomes less than 150% of the federal poverty level (FPL) to 17.2% for women with family incomes 450% or more of the FPL (Figure 3, Table 3).
• The percentage of women who had ever used any medical help to get pregnant increased with higher levels of family income, with the percentage for those with family incomes 450% or more of the FPL (14.8%) being nearly three times higher than those whose family incomes were less than 150% FPL (5.0%).
• Use of any medical help to prevent pregnancy loss did not vary by family income.

Current health insurance coverage

• Among women ages 20-49 in 2022-2023 with private health insurance, 16.0% had ever used any fertility services, which was higher than the percentage of women who had public insurance (9.4%) or were uninsured (9.6%) (Figure 4, Table 4).
• A higher percentage of women with private health insurance had ever used any medical help to get pregnant (13.6%) compared with women who had public insurance (4.4%) or who were uninsured (5.4%).
• Use of any medical help to prevent pregnancy loss did not vary by current health insurance coverage.

Summary

Among women ages 20-49 in 2022-2023, 13.7% had ever used any fertility services, and the percentage who had used any medical help to get pregnant was nearly twice the percentage who had used any medical help to prevent pregnancy loss. Previous research has shown that those who use fertility services may not be representative of all people who have fertility problems (4-8). This report shows that the use of any medical help to get pregnant varied by race and Hispanic origin, family income, and current health insurance coverage, but ever use of any medical help to prevent pregnancy loss did not vary by those socioeconomic characteristics. Understanding these patterns in the ever use of fertility services is important for gauging the potential demand for fertility services in the United States among various sociodemographic groups.

Definitions

Hispanic origin and race: The 1997 Office of Management and Budget guidelines for the presentation of race and ethnicity data in federal statistics were used for these classifications (9). Recode variable HISPRACE2 and additional nonpublic variables were used to categorize non-Hispanic respondents' race for those who selected only one racial group. Respondents had the option to select more than one racial group, and respondents categorized as Hispanic may be of any race or combination of races (9). Given the heterogeneity of women categorized as non-Hispanic other or multiple races, this category is not presented separately in this report.

Family income as a percentage of the federal poverty level: The POVERTY recode is based on a comparison of each respondent's family income with the federal poverty level (FPL) for a family of that size, as defined by the U.S. Census Bureau (10).

Current health insurance coverage: The recode CURR_INS is a measure of health insurance coverage at the time of survey based on a hierarchical categorization of coverage types into mutually exclusive categories when respondents reported more than one type.

Data source and methods

Details about the survey content, administration, response rates, planning, and funding for the 2022-2023 NSFG can be found in the documentation on the NSFG webpage (11,12). While the 2022-2023 survey included information from 5,586 females ages 15-49, this report is based on data from 4,856 women ages 20-49 (11). All estimates are representative of the U.S. household population of women ages 20-49 in 2022 (11). Statistics for this report were produced using SAS-callable SUDAAN software version 11.0.3 (13) to account for the complex sample design of NSFG. Differences between percentages were evaluated using two-tailed t tests at the 5% level. A weighted least squares regression was used to test the statistical significance of the observed linear trends across family income. Statistical power to detect differences between groups was limited for some comparisons. The data presented in this report are bivariate associations that may be explained by other factors not controlled for in the figures or included in the report. Due to the change in survey design to multimode and lower response rates due to a number of factors (11), comparisons of these results with previous NSFG data releases should be made with caution. All estimates presented meet NCHS data presentation standards for proportions (14).

About the authors

Colleen N. Nugent and Anjani Chandra are with the National Center for Health Statistics, Division of Health Interview Statistics.

References

1. Nugent C, Chandra A. QuickStats: Percentage of women aged 25-44 years who had ever used infertility services, by type of service-National Survey of Family Growth, United States, 2006-2010 and 2015-2019. MMWR Morb Mortal Wkly Rep 2021;70:1433. DOI: https://dx.doi.org/10.15585/mmwr.mm7040a5.
2. Nugent CN, Chandra A. Infertility and impaired fecundity in women and men in the United States, 2015-2019. Natl Health Stat Report. 2024 Apr;(202):1-19. DOI: https://dx.doi.org/10.15620/cdc/147886.
3. Chandra A, Copen CE, Stephen EH. Infertility and impaired fecundity in the United States, 1982-2010: Data from the National Survey of Family Growth. Natl Health Stat Report. 2013 Aug;(67):1-19. PMID: 24988820.
4. Chandra A, Copen CE, Stephen EH. Infertility service use in the United States: Data from the National Survey of Family Growth, 1982-2010. Natl Health Stat Report. 2014 Jan;(73):1-21. PMID: 24467919.
5. Chandra A, Patel D, Warner L. Infertility. In: Barfield WD, Besera G, editors. From data to action: CDC's public health surveillance for women, infants and children. 2nd ed. U.S. Department of Health and Human Services; 2020. 107-124. DOI: https://dx.doi.org/10.13140/RG.2.2.17110.93761.
6. Dongarwar D, Mercado-Evans V, Adu-Gyamfi S, Laracuente ML, Salihu HM. Racial/ethnic disparities in infertility treatment utilization in the US, 2011-2019. Systems Biology in Reproductive Medicine. 2022 May 4;68(3):180-9. DOI: https://doi.org/10.1080/19396368.2022.2038718.
7. Kelley AS, Qin Y, Marsh EE, Dupree JM. Disparities in accessing infertility care in the United States: results from the National Health and Nutrition Examination Survey, 2013-16. Fertility and Sterility. 2019 Sep 1;112(3):562-8. DOI: https://doi.org/10.1016/j.fertnstert.2019.04.044.
8. Persily J, Stair S, Najari BB. Access to infertility services: Characterizing potentially infertile men in the United States with the use of the National Survey for Family Growth. Fertil Steril. 2020 Jul 1;114(1):83-8. DOI: https://doi.org/10.1016/j.fertnstert.2020.03.005.
9. Office of Management and Budget. Revisions to the standards for the classification of federal data on race and ethnicity. Fed Regist. 1997 Oct 30;62(210):58782-90. Available from: https://www.govinfo.gov/content/pkg/FR-1997-10-30/pdf/97-28653.pdf.
10. U.S. Census Bureau. Poverty thresholds. 2023. Available from: https://www.census.gov/data/tables/time-series/demo/income-poverty/historical-poverty-thresholds.html.
11. National Center for Health Statistics. Public-use data file documentation: 2022-2023 National Survey of Family Growth, user's guide. 2024. Available from: https://www.cdc.gov/nchs/data/nsfg/guidefaqs/NSFG-2022-2023-UsersGuide-revJuly2025.pdf.
12. National Center for Health Statistics. 2022-2023 National Survey of Family Growth: Public-use data files, codebooks, and documentation. 2024. Available from: https://www.cdc.gov/nchs/nsfg/nsfg-2022-2023-puf.htm.
13. RTI International. SUDAAN (Release 11.0.3) [computer software]. 2018.
    
14. Parker JD, Talih M, Malec DJ, Beresovsky V, Carroll M, Gonzalez JF, et al. National Center for Health Statistics data presentation standards for proportions. Vital Health Stat 2. 2017 Aug;(175):1-22. PMID: 30248016.

Suggested citation

Nugent CN, Chandra A. Use of fertility services in women ages 20-49 in the United States: 2022-2023. NCHS Data Brief. 2025 Dec;(542):1-10. DOI: https://dx.doi.org/10.15620/cdc/174628.

Copyright information

All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

National Center for Health Statistics

Brian C. Moyer, Ph.D., Director
Amy M. Branum, Ph.D., Associate Director for Science

Division of Health Interview Statistics

Stephen J. Blumberg, Ph.D., Director
Anjel Vahratian, Ph.D., M.P.H., Associate Director for Science