IVF clinics and success data in Massachusetts
5.4% of births, U.S. 2.3%.

Massachusetts in CDC's state brief

3,717 of the 69,137 infants born to Massachusetts mothers in 2021 were conceived with ART. The procedures performed for residents that year, 11,650 in total, included 9,517 embryo transfers and resulted in 4,011 live-birth deliveries and 4,213 live-born infants. The first figure counts births in the calendar year; the second follows the procedures started in 2021.

Source: CDC, State-Specific ART Surveillance, 2021 Data Brief (published December 2023). Procedures exclude cycles in which eggs or embryos were only banked.

Every figure is assigned to the patient's state of residence, not to the clinic's location. CDC warns that state figures may therefore not reflect the clinics in that state, since some patients travel.

Transfer and the two-week wait

Map to the Positive walks through the last two phases of IVF, the ones many women find hardest:

• Embryo transfer: fresh in the same cycle or frozen in a later one; many centers now favor frozen transfer for slightly better rates. It takes 10 to 15 minutes, needs no anesthesia, and you rest 15 to 30 minutes at the office.
• Normal activity afterward: there is no evidence that prolonged rest improves outcomes. Progesterone supplementation begins, usually vaginal.
• The wait (14 days): implantation happens around day 9 to 11 after the transfer if it works, and a blood beta-hCG test follows on day 12 to 14.
• The result: if positive, progesterone continues and an ultrasound follows in 2 weeks; if negative, the medication stops and planning begins for the next attempt.

The book calls the two-week wait the most emotionally difficult stretch of the process.

This is one chapter. The map has 42.

Chapter 35 of Map to the Positive, in Station IV, explains IVF from the first injection to the pregnancy test, with the questions to ask before you start. The same station covers choosing a doctor and the full treatment ladder.