Racial disparities in in vitro fertilization outcomes

Capsule:
Black and Asian women undergoing in vitro fertilization have significantly lower odds of both clinical intrauterine pregnancy and live birth compared with white women.

Authors:
Dana B. McQueen, M.D., M.A.S., Ann Schufreider, M.D., Sang Mee Lee, Ph.D., Eve C. Feinberg, M.D., Meike L. Uhler, M.D.

Volume 104, Issue 2, Pages 398-402

Abstract:

Objective:
To evaluate the impact of race on in vitro fertilization (IVF) outcomes.

Design:
Retrospective analysis.

Setting:
Private practice.

Patient(s):
All women who underwent a first autologous IVF cycle at Fertility Centers of Illinois from January 2010 to December 2012.

Intervention(s):
Information was collected on baseline characteristics, cycle parameters, and outcomes. Race was self-reported.

Main Outcome Measure(s):
Clinical intrauterine pregnancy and live birth rates.

Result(s):
A total of 4,045 women were included: 3,003 white (74.2%), 213 black (5.3%), 541 Asian (13.4%), and 288 Hispanic women (7.1%). A multivariable logistic regression was performed to control for confounders. Compared with white women, the adjusted odds ratio for clinical intrauterine pregnancy was 0.63 (95% confidence interval [CI] 0.44–0.88) in black women, 0.73 (95% CI 0.60–0.90) in Asian women, and 0.82 (95% CI 0.62–1.07) in Hispanic women. The adjusted odds ratio for live birth was 0.50 (95% CI 0.33–0.72) in black women, 0.64 (95% CI 0.51–0.80) in Asian women, and 0.80 (95% CI 0.60–1.06) in Hispanic women compared with white women. The spontaneous abortion rate was 14.6% in white women versus 28.9% in black women, 20.6% in Asian women, and 15.3% in Hispanic women.

Conclusion(s):
Black and Asian women had lower odds of clinical intrauterine pregnancy and live birth and higher rates of spontaneous abortion compared with white women. Further research is needed to better characterize the mechanisms associated with this racial disparity and to improve treatment options for black and Asian women.

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