Which IVF clinics lead CDC-reported live-birth rates?

How These Rankings Are Calculated

The PlainFertility ranking tables on this page are computed directly from the CDC National Assisted Reproductive Technology Surveillance System (NASS) public-use file. CDC's NASS data covers reporting clinics that participate in the federally mandated reporting program under Section 2 of the Fertility Clinic Success Rate and Certification Act of 1992 (Public Law 102-493). Reporting is annual and clinic-level. Each ranking section above is generated by ordering clinics or states by a single, clearly named score field from the latest published NASS report year, then taking the top five rows. The score-field definition matches the CDC field exactly; we do not blend, weight, or composite multiple fields into a proprietary "PlainFertility Score". That choice keeps the ranking auditable: a clinic's position on this page is reproducible from CDC's downloadable public-use file with a single SQL ORDER BY.

Age-Banded Success Rate Tables Explained

The CDC NASS dataset publishes live-birth-per-intended-egg-retrieval rates banded by patient age at the time of cycle start (under 35, 35–37, 38–40, and a single band for everyone over 40). The age band is a strong driver of fertility outcomes, measurably stronger than clinic-level treatment-protocol differences for most patient populations, so CDC reports clinic-level rates within each age band separately rather than as a single combined number. The "Best Success Rate, Under 35", "Best Success Rate, 35–37", and "Best Success Rate, 38–40" tables on this page each draw from the corresponding banded CDC field. A clinic at the top of one age band may not be at the top of another; rotation between bands is the norm, not the exception. CDC also publishes notes warning against direct clinic-to-clinic comparison because patient-mix differences (diagnosis severity, prior treatment history, donor versus own-egg cycles) can swing reported rates without indicating any difference in clinical quality.

Volume vs. Quality, Why Both Matter

The "Highest Volume Clinics" ranking sorts clinics by total reported ART cycles in the most recent NASS year. Volume is not a quality metric on its own, but it is a useful crawl-pathway: high-volume clinics tend to have deeper public-data records, more reviewer attention from state health departments, and broader patient bases that smooth out random variation in single-year success-rate readings. A small clinic with five cycles in a year can have a 100% success rate or a 0% success rate driven entirely by chance; a clinic with 800 cycles cannot. For prospective patients comparing clinics, looking at both the success rate AND the cycle volume gives a more honest picture than either field alone. Two-year and three-year rolling averages, when available in the CDC publication, further reduce single-year noise and are the figures most often cited in peer-reviewed reproductive-medicine literature.

State-Level Aggregates

The state-level rankings on this page ("States with Most Clinics" and "States, Best Average Success Rate") aggregate clinic-level NASS records up to the state level. Average success rate at the state level is computed as the unweighted mean of clinic-level success rates within the state, not weighted by cycle volume. That choice is deliberate: a weighted mean would let one or two very large clinics dominate the state figure, hiding the variation in care quality across the state. The unweighted state mean is best read as "what is the typical clinic in this state delivering?" rather than "what is a randomly chosen patient in this state likely to experience?". For the latter question, the volume-weighted average is more appropriate; we plan to add that view in a future revision of this page.

What These Rankings Do NOT Capture

A ranking page like this one cannot replace a consultation with a board-certified reproductive endocrinologist. The CDC NASS dataset does not capture: out-of-pocket cost or insurance acceptance, patient experience and wait times, specific diagnoses or treatment protocols, time-to-pregnancy across multiple cycles, single-embryo-transfer rates and multiple-birth complication rates, donor-egg versus own-egg outcome differentials beyond the headline figure, or any quality-of-life or psychological-support metrics. Patients evaluating clinics for their own treatment should look at the CDC ART Reports directly (linked from the methodology page) and supplement with state-level inspection records, peer-reviewed publication history of the clinic's medical director, and direct conversation with the clinic's coordinator about patient-mix and case-acceptance criteria. PlainFertility makes the CDC data more browsable; it does not substitute for clinical judgment.

Download the state clinic-inventory extract: clinic-inventory-by-state.csv (same CSV as the homepage Dataset, government-works).