Racial Disparities in ART Outcomes
ASRM Office of Public Affairs21 October 2014
Honolulu, Hawaii – Health care outcomes in the US often have significant disparities with race often a key component. According to new research presented at the 70th Annual Meeting of the American Society for Reproductive Medicine, it appears race may be an important factor in infertility care, as well.
A Chicago based research team examined over 4000 IVF cycles between 2010 and 2012 to explore the impact of race. Using advanced statistical techniques the teams examined the impact of several factors on success rates of infertility treatments. The variables included age, BMI, levels of two important hormones, smoking, fertility diagnosis and number of embryos transferred. They found that pregnancy rates for African American women were lower (16.9%) than for white women (30.7%), while miscarriage rates were higher among black women (28.9%) than in white women (14.6%).
These racial differences were present for women seeking to build their families by using donated eggs, as well. Investigators from Columbia University sought to isolate the impact of race, and its association with uterine pathology, on the likelihood of success of a donor egg cycle. Because African American women are at greater risk of uterine pathology, the researchers attempted to match African American egg donor recipients with white women with similar histories of fibroid and uterine surgeries. Even with these controls, African American women still had lower success rates when using donated eggs (32%) than did white women (44%).
Two other studies presented at the meeting examined other aspects of race. Racial disparities appear to extend beyond infertility success rates, as well. Examining answers to an on-line survey testing respondents (women of child bearing age) knowledge of fertility, researchers found that cultural differences played a role in women’s knowledge of fertility factors. For example, 80% of the African American respondents correctly stated that Sexually Transmitted Diseases (STDs) could impact fertility, while only 68% of white respondents knew that.
Suffering from infertility is difficult for all patients; however there may be racial differences in the burden felt by women. Researchers performed an on-line survey of reproductive age women to explore differences in how groups felt about infertility. The results showed that Asian women carried the greatest subjective burden related to infertility. While the stress related to getting pregnant was similar across groups, Asian women were less likely to participate in fertility related discussions.
"Racial differences play a role in the causes of infertility and impact reproductive success. It is important that we strive to better understand the biology and cultural influences that might contribute to these disparities and study interventions that will improve outcomes. Educating the public about infertility prevention is an important goal of the ASRM, " said Rebecca Z. Sokol, MD, MPH, President of the American Society for Reproductive Medicine.
P-416 DB McQueen et al, “Racial Disparities in IVF”
P-418 LC Grossman et al, “African American Recipients of Donor Oocytes Have Lower Embryo Implantation Rates as Compared to Matched Caucasian Controls”
P-308 JC Yano et al, “Racial Differences in Fertility Knowledge and Awareness Amongst Reproductive Age Women in the US”
P-309 JC Yano et al, “Racial Differences in Fertility Related Subjective Burden Amongst Reproductive Age Women in the US”