Impacts of COVID-19 on Medically Assisted Live Birth Rates in the United States in 2020 and 2021

Abstract

Initial declines in births due to medically assisted reproduction (MAR) in December 2020 have been documented. However, the longer-term impact of COVID-19 on U.S. MAR birth rates has not yet been evaluated. Negative-binomial regression analyses were employed using counts of MAR births from the National Vital Statistics System and female population counts from the Current Population Survey as the exposure variable. Interaction terms were used to investigate whether trends varied by sociodemographic groups. The descriptive analyses showed sharp declines in the percentage of births due to MAR in December 2020 (1.05%) and January 2021 (1.08%). Multivariable negative-binomial regression showed the incident rates of MAR births were lower in December 2020 relative to all other periods with the exception of January 2021 (IRR = 0.97, 95% Confidence Interval: 0.77–1.22). Negative-binomial regression analyses with interaction terms found the decline and rebound in MAR births differed by educational attainment. Overall, however, the yearly incidence rates of MAR births in 2020 and 2021 were not different from rates from prior years (2017–2019). Thus, COVID-19 service suspension likely had a substantive effect on U.S. MAR birth rates, but this reduction quickly rebounded to pre-pandemic levels. This study extends prior research, which focused on data from 2020, and sheds further light on behavior related to MAR use and its potential demographic implications during the pandemic.