TEXAS OUTPACES NATIONAL GROWTH IN ASSISTED REPRODUCTIVE TECHNOLOGY–ASSOCIATED BIRTHS: A POPULATION-BASED ANALYSIS

Objective: To evaluate trends in assisted reproductive technology (ART)–associated births in Texas compared with national patterns in the United States. Design: Population-based retrospective observational study. Materials and Methods: Final natality data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database were analyzed for 2016–2019, the period during which assisted reproductive technology (ART) use was consistently reported on U.S. birth certificates. Births were grouped by maternal state of residence (Texas versus United States overall) and year. The primary outcome was the proportion of births conceived using ART, defined by the birth certificate indicator “Assisted Reproductive Technology Used.” Temporal trends were analyzed using regression modeling to compare annual changes in ART-associated births between Texas and national trends. Results: In Texas, the proportion of ART-associated births increased from 0.265% (1,054 of 398,047 births) in 2016 to 0.672% (2,537 of 377,599 births) in 2019. Nationally, ART-associated births increased from 0.995% (78,498 of 7,891,750 births) in 2016 to 1.290% (96,712 of 7,495,080 births) in 2019. Regression analysis demonstrated increasing odds of ART-associated birth annually in both Texas and the United States, with a significantly steeper increase observed in Texas compared with national trends (interaction p < 0.001). The largest increase in Texas occurred between 2018 and 2019. Conclusions: ART-associated births increased nationally from 2016–2019; however, Texas experienced a disproportionately greater rate of growth. These findings suggest evolving regional patterns in reproductive technology utilization and highlight potential expansion of ART access within Texas.