Trends of racial disparities in assisted reproductive technology outcomes in black women compared with white women: Society for Assisted Reproductive Technology 1999 and 2000 vs. 2004-2006

Objective: To determine trends in assisted reproductive technology (ART) in black and white women by comparing Society for Assisted Reproductive Technology (SART) database outcomes for 2004-2006 with previously reported outcomes for 1999 and 2000. Design: Retrospective, cohort study. Setting: The SART member clinics that performed at least 50 cycles of IVF and reported race in more than 95% of cycles. Patient(s): Women receiving 158,693 IVF cycles. Intervention(s): In vitro fertilization using nondonor embryos. Main Outcome Measure(s): Live birth rate per cycle started. Result(s): Reporting of race increased from 52% to 60%. The proportion of black, non-Hispanic (BNH) women increased from 4.6% to 6.5%. For BNH women using fresh embryos and no prior ART, significant increasing trends were observed for older age, male factor, uterine factor, diminished ovarian reserve, and ovulation disorders. The BNH women were 2.5 times more likely to have tubal factor for those cycles with no prior ART. The proportion of live births per cycle started increased across all groups over time, although greater increases occurred for white women. Conclusion(s): There seems to be widening disparities in IVF outcomes between BNH and white women, perhaps attributable to poor prognostic factors among black women. Race continues to be a marker for prognosis for ART outcomes and should be reported.