Disparity in assisted reproductive technologies outcomes in black women compared with white women

David Seifer, Linda M. Frazier, David A. Grainger

Research output: Contribution to journalArticle

75 Citations (Scopus)

Abstract

Objective: To compare success rates in black and white women undergoing IVF. Design: Retrospective cohort study. Setting: Society for Assisted Reproductive Technology member clinics in 1999-2000 that performed ≥50 cycles of IVF and reported race/ethnicity in >95% of cycles. Patient(s): Women receiving 80,309 IVF cycles. Intervention(s): IVF using nondonor embryos. Main Outcome Measure(s): Live-birth rate per cycle started. Result(s): Black, white, and other race/ethnicity women underwent 3666 (4.6%), 68,607 (83.5%), and 8036 (11.9%) IVF cycles, respectively. Spontaneous abortions were more common among black women. The live-birth rate was 26.3% (95% confidence interval [CI], 25.9%-26.7%) among white women compared with 18.7% (95% CI, 17.5%-20.1%) among black women (rate ratio, 1.41). After controlling for increased tubal and uterine factor infertility among blacks and other characteristics, black race was an independent risk factor for not achieving a live birth (adjusted relative risk, 1.21; 95% CI, 1.12-1.36 if no prior ART, and RR, 1.38; 95% CI, 1.20-1.57 if prior ART). For cryopreserved embryo cycles, live-birth rates were equivalent. Conclusion(s): Black women, who represented 7.8% of married reproductive-age women in the United States at that time, were underrepresented among IVF recipients. Race is a marker for prognosis that is not explained by characteristics available in the registry data set.

Original languageEnglish (US)
Pages (from-to)1701-1710
Number of pages10
JournalFertility and Sterility
Volume90
Issue number5
DOIs
StatePublished - Nov 2008
Externally publishedYes

Fingerprint

Assisted Reproductive Techniques
Live Birth
Birth Rate
Confidence Intervals
Embryonic Structures
Spontaneous Abortion
Infertility
Registries
Cohort Studies
Retrospective Studies
Outcome Assessment (Health Care)

Keywords

  • African Americans
  • assisted reproductive techniques
  • black women
  • delivery of health care
  • ethnic groups
  • in vitro fertilization
  • Infertility
  • race
  • socioeconomic factors

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine

Cite this

Disparity in assisted reproductive technologies outcomes in black women compared with white women. / Seifer, David; Frazier, Linda M.; Grainger, David A.

In: Fertility and Sterility, Vol. 90, No. 5, 11.2008, p. 1701-1710.

Research output: Contribution to journalArticle

Seifer, David ; Frazier, Linda M. ; Grainger, David A. / Disparity in assisted reproductive technologies outcomes in black women compared with white women. In: Fertility and Sterility. 2008 ; Vol. 90, No. 5. pp. 1701-1710.
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abstract = "Objective: To compare success rates in black and white women undergoing IVF. Design: Retrospective cohort study. Setting: Society for Assisted Reproductive Technology member clinics in 1999-2000 that performed ≥50 cycles of IVF and reported race/ethnicity in >95{\%} of cycles. Patient(s): Women receiving 80,309 IVF cycles. Intervention(s): IVF using nondonor embryos. Main Outcome Measure(s): Live-birth rate per cycle started. Result(s): Black, white, and other race/ethnicity women underwent 3666 (4.6{\%}), 68,607 (83.5{\%}), and 8036 (11.9{\%}) IVF cycles, respectively. Spontaneous abortions were more common among black women. The live-birth rate was 26.3{\%} (95{\%} confidence interval [CI], 25.9{\%}-26.7{\%}) among white women compared with 18.7{\%} (95{\%} CI, 17.5{\%}-20.1{\%}) among black women (rate ratio, 1.41). After controlling for increased tubal and uterine factor infertility among blacks and other characteristics, black race was an independent risk factor for not achieving a live birth (adjusted relative risk, 1.21; 95{\%} CI, 1.12-1.36 if no prior ART, and RR, 1.38; 95{\%} CI, 1.20-1.57 if prior ART). For cryopreserved embryo cycles, live-birth rates were equivalent. Conclusion(s): Black women, who represented 7.8{\%} of married reproductive-age women in the United States at that time, were underrepresented among IVF recipients. Race is a marker for prognosis that is not explained by characteristics available in the registry data set.",
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